参附注射液复合异丙酚对围手术肝缺血-再灌注损伤影响的研究

COMPOUND INFLUENCE OF SHENFU INJECTION AND PROPOFOL ON ISCHEMIA-REPERFUSION INJURY OF LIVER IN PEROPERATIVE PERIOD

[目的]探讨参附注射液、异丙酚复合使用对围手术期缺血-再灌注损伤肝脏的保护作用及其机制。[方法]选择60例肝叶手术患者,随机分为对照组(C组)、参附注射液组(SFI组)、异丙酚组(P组)、参附注射液复合异丙酚组(SFI+P组)。动态观察内皮素-1(ET-1)含量、脂质过氧化物(LPO)浓度、一氧化氮(NO)含量、谷丙转氨酶(ALT)活性变化。[结果]与对照组比较,参附注射液组、异丙酚组、参附注射液加异丙酚组LPO、内皮素-1(ET-1)及ALT活性均显著下降(P﹤0.05或P﹤0.01),血浆一氧化氮(NO)均明显增高(P﹤0.05或P﹤0.01)。[结论]参附注射液复合异丙酚可通过降低体内脂质过氧化物、减轻脂质过氧化反应,可通过调节NO和ET-1水平对肝缺血再灌注损伤发挥更好的保护作用。

[Objective] To explore the protective effect and mechanism of Shenfu injection （SFI） and propofol （P） on hepatic ischemia-repedusion injury （HIRI） in pereperative period. [ Methods] Sixty patients scheduled for hepatic surgery were randomly divided into control group, SFI group, P group and SFI＋ P group （each group had fifteen patients）. Changes of nitric oxide （NO）, lipid peroxide （LPO）, endothelin -I （ET-1） and alanine aminotransferase （ALT） activity Were dynamicaUy observed. [Results] Compared with the control group, NO concentration significantly increased, and LPO concentration, ET-1 and ALT value were significantly lower （P〈 0.05 and P〈 0.01） in the SFI group, the P group and the SFI ＋ P group during HIR/period. [Conclusion] Combination of Shenfu injection and pmpefol shows more protective effects on liver, by de- creasing lipid peroxide level, reducing lipid pemxidation and adjusting NO-ET-1 imbalance, to avoid hepatic ischemia-reper- fusion injury after hepatectomy.