乌司他丁在肝移植术中对肾损伤的保护作用

Protective effects of ulinastatin on kidney function injury during piggyback orthotopic liver transplantation operation

目的研究背驮式肝移植手术中乌司他丁(Ulinastatin,UTI)对急性肾损伤的影响。方法行背驮式原位肝移植(PBOLT)手术患者40例,随机分为对照组(n=20)、UTI组(n=20)。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和尿样比较两组血浆丙二醛(MDA)、超氧化物歧化酶(SOD)、β2-微球蛋白(β2-MG)和尿β2-微球蛋白(Uβ2-MG)水平。结果与无肝前期相比,无肝期和新肝期对照组血和尿中各项指标水平均较术前显著性升高(P<0·05),UTI组各项指标的水平无明显变化(P>0·05)。结论乌司他丁对背驮式肝移植手术中体内发生的急性肾损伤有保护作用。

Objective To evaluate the effects of ulinastatin(UTI) on acute kidney injury during piggyback orthotopic liver transplantation(PBOLT) operation.Methods Forty patients with end-stage liver diseases undergoing PBOLT were randomly divided into two groups:UTI group received intravenous infusion UTI continuously during the whole operation(group U,n=20) and control group received the same amount of normal saline instead of UTI (group C,n=20).Internal jugular vein blood and urine samples were collected to test concentration of plasma malonyldialdehyde(MDA),superoxide dismutase(SOD), beta2-microglobulin(β2-MG) and urine beta2-microglobulin(Uβ2-MG) on 6 time points:before skin incision(Ti),120 min after skin incision(T2),30 min in anhepatic phase(T3),5,60 and 120 min after reperfusion phase(T4,T5,T6).Result The levels of MDA,SOD,β2-MG and Uβ2-MG were significantly increased at T4 and kept high levels on the following time in group C(P<0.05);the changes were not significant in group U.Conclusion The protective effects of UTI exists in acute kidney injury during PBOLT.