摘要
目的观察七氟烷后处理对肝癌根治术患者肝缺血再灌注损伤的影响。方法将60例择期进行肝癌根治术患者随机分为试验组30例和对照组30例。对照组予以静脉持续输注异丙酚8 mg·kg-1·h-1+瑞芬太尼1μg·kg-1·h-1+顺势阿曲库铵1μg·kg-1·h-1;试验组在对照组的基础上,于最后一次肝门阻断开放后吸入2%七氟烷30 min,之后用纯氧6 L·min-1洗脱15 min。于术前(T0)、手术结束(T1)、术后1 d(T2),3 d(T3)、5 d(T4)、7 d(T5)各时间点取静脉血10 m L,比较2组各时间点血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)和白细胞介素-10(IL-10)浓度,以及术后住院天数。结果与术前比较,2组患者术后血清AST、ALT、MDA、TNF-α、IL-1浓度明显升高(P<0.05),试验组AST、ALT、MDA浓度在T2、T3、T4和T5时间点和TNF-α、IL-1浓度在T2、T3和T4时间点均显著低于对照组(P<0.05),试验组SOD浓度于术后明显升高(P<0.05),对照组各时间点SOD浓度变化不明显,试验组血清SOD和IL-10浓度于T2、T3、T4时间点显著高于对照组(P<0.05)。试验组患者术后住院天数明显短于对照组(P<0.05)。结论七氟烷后处理能减轻肝癌根治术患者的肝缺血再灌注损伤,可能是通过抑制TNF-α、IL-1激活和释放,抑制氧自由基的生成,促进IL-10的激活和释放来达到的。
Objective To evaluate the effect of sevoflurane postconditioning on hepatic ischemia reperfusion injury in patients with ra-dical resection of liver cancer. Methods Sixty patients undergoing elective radical resection of liver cancer were randomly divided into control group（ 30 cases） and treatment group（ 30 cases）. Patients in control group were given propofol 8 mg·kg- 1·h- 1＋ remifentanil 1 μg·kg- 1·h- 1and cisatracurium 1 μg · kg- 1·h- 1. Patients in treatment group were given the same methods with control group,and inhaled 2% sevoflurane for 30 min after disparking the blood stream of hepatic hilum,and clean them for 15 min. 10 m L of venous blood was collected at the each time point： the time of pre- operation（ T0）,the end of operation（ T1）,post operation 1 d（ T2）,3 d（ T3）,5 d（ T4） and 7 d（ T5）. The serum alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,malondialdehyde（ MDA）,superoxide dismutase（ SOD）,tumor necrosisfactor- α（ TNF- α）,interleukin- 1（ IL- 1） and interleukin- 10（ IL- 10） in the different time point between two groups were compared. And the hospitalization time between two groups was also compared. Results AST,MDA,SOD,TNF- α and IL- 1 were higher than T0 in each group after operation（ P〈0. 05）. ALT,AST and MDA of treatment group were significantly lower than those of control group in the T2、T3、T4and T5（ P〈0. 05）. TNF- α and IL- 1of treatment group were significantly lower than those of control group in the T2,T3 and T4（ P〈0. 05）. SOD and IL- 10 of treatment group were significantly higher than those of control group in the T2,T3,T4 and T5（ P〈0. 05）.The length of stay in hospital of treatment group was significantly shorter than that of control group（ P〈0. 05）.Conclusion Sevoflurane postconditioning can alleviate hepatic ischemia reperfusion injury on patients under radical resection of liver cancer through the decrease of the activation and release of TNF- α,and IL- 1,the
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2015年第23期2300-2302,共3页
The Chinese Journal of Clinical Pharmacology
基金
浙江省医学会临床科研基金资金项目(2011ZYC-A52)
宁波市卫生局医学科技计划基金资助项目(2013A01)
关键词
七氟烷
后处理
肝癌根治术
缺血再灌注损伤
sevoflurane
postconditioning
radical resection of liver cancer
hepatic ischemia reperfusion injury
