摘要
目的研究乌司他丁对肝脏手术后炎症介质释放及氧化反应的影响,探讨其保护患者术后肝功能的机理。方法通过前瞻、随机、对照临床研究,将我院肝脏外科中心收治的肝切除患者30例分为治疗组和对照组,治疗组于手术当天和术后3 d静脉滴注乌司他丁;全部患者分别在术前及术后抽外周静脉血测定淋巴细胞亚群分类(CD4、CD8)、急性反应蛋白(CRP)水平以及白细胞介素-1(IL-1)和IL-6、肿瘤坏死因子(TNF-α)、一氧化氮合酶(iNOS)的基因表达。结果应用乌司他丁后,治疗组患者术后12 h TNF-α和iNOS均较对照组有明显下降(0．053±0．02和0．12±0．04 vs．0．084±0．01和0．21±0．02,P<0．05);IL-1的释放高峰被推后;但对CD4、CD8和CRP的变化却无明显作用。结论乌司他丁可能通过特异性抑制或调节某些促炎因子的水平来保护肝脏术后的肝功能;这种保护作用还可能同抗氧化作用有关。
Objective To study the effect of urinary trypsin inhibitor （UTI） on the release of inflammatory media and oxidation reaction and the mechanism by which UTI protects postoperative liver function following hepatectomy. Methods This was a prospective, randomized, controlled clinical trail, in which cases undergoing hepatectomy were divided into control group （ n = 15 ） and treatment group （ n = 15）. UTI was administered beginning the day of operation and three days post-op consecutively in the treatment group. Serum CD4, CD8, C-reactive protein （CRP）, and gene expressions of IL-1, I1-6, TNF- alpha, iNOS were measured. Results TNF-alpha and iNOS levels significantly decreased in treatment group compared with control 12 hours after surgery （ 0. 053 ±0. 02 ＆ 0. 12 ±0. 04 vs. 0. 084 ±0. 01 ＆ 0. 21 ±0. 02, all P 〈 0. 05 ）. The plasma peak of IL-1 was postponed but UTI failed to alter the level of CD4, CD8, and CRP. Conclusions UTI may protect liver function in patients undergoing hepatectomy by inhibting or modulating certain pro-inflammatory cytokines through anti-oxidation effects.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第7期496-499,共4页
Chinese Journal of General Surgery
基金
北京协和医院科学研究基金资助项目(200324A)
