乌斯他丁对肝移植术中血浆细胞因子和SOD、MDA的影响

Effects of ulinastatin on plasma inflammatory cytokines, MDA and SOD during piggyback orthotopic liver transplantation operation

目的:研究背驮式肝移植手术中乌斯他丁(ulinastatin,UTI)对血浆细胞因子和丙二醛(MDA)、超氧化物歧化酶(SOD)的影响。方法:行背驮式原位肝移植(PBOLT)手术病人20例,随机分为对照组(C组,n=10),UTI持续泵注组(U组,n=10)。于麻醉后开腹前、无肝前期120min、无肝期30min、新肝期5、60、120min6个时点分别采颈内静脉血比较两组血浆肿瘤坏死因子-α(TNF鄄α)、白细胞介素(IL)鄄1、IL鄄6、MDA和SOD水平。结果:与无肝前期相比,在无肝期和新肝期对照组血中上述指标浓度较术前显著升高(P<0.05),应用UTI组浓度水平无明显变化(P>0.05)。结论:①背驮式肝移植手术特别是新肝期,体内发生了急性炎性反应;②乌斯他丁能减轻此类手术中的急性炎性反应。

Objective:To evaluate the effects of ulinastatin(UTI) on the levels of plasma cytokines,malondialdehyde(MDA) and superoxid dismutase(SOD) during piggyback orthotopic liver transplantation(PBOLT) operation. Methods:Twenty patients with end-stadge liver diseases undergoing PBOLT were randomly divided into two groups:UTI group received intravenous infusion UTI continuously during the whole operation(group U, n = 10) and control group received the same amount of normal asline instead of UTI(group C, n = 10). Internal jugular vein blood samples were collected to measure plasma concentration of TNF-α, IL-1, IL-6, MDA and SOD on 6 time points:before skin incision(T1), 120 min after skin incision(T2), 30 min in anhepatic phase(T3), 5 min, 60 min and 120 min after reperfusion phase(T4,T5,T6). Results:The levels of TNF-α,IL-1,IL-6,MDA and SOD were significantly increased at T4 and kept high levels on the following times in group C(P < 0.05); the changes were not significant in group U.Conclusion:①Acute inflammatory actions were observed during the PBOLT, especially in the reperfusion phase;②The protective effects of UTI exist on Acute inflammatory actions during PBOLT.