参麦注射液对肝脏缺血再灌注损伤的临床研究

Clinical Research of the Protective Effects of Shenmai Injection Against Hepatic Ischemia Reperfusion Injury

目的观察参麦注射液对肝切除手术时肝脏缺血再灌注损伤的保护作用。方法择期行肝切除术的患者62例，随机分为参麦组（n=33）和对照组（n=29）。在肝门阻断前30min，对照组经静脉滴入5％葡萄糖盐水250ml；参麦组滴入5％葡萄糖盐水250ml＋参麦注射液2ml／kg体重，术后第1～3天继续使用．两组患者分别在肝门阻断前及肝门开放后24小时和48小时，检测血清谷丙转氨酶（ALT）、谷草转氨酶（AST）和乳酸脱氢酶（LDH）。在肝门阻断前和肝门开放后60min切取肝脏组织匀浆取上清，ELLISA方法进行髓过氧化物酶（MPO）、超氧化物歧化酶（SOD）和丙二醛（MDA）的检测。结果两组患者在肝门阻断之前检测血ALT、AST、LDH均正常，MPO、MDA、SOD的测定值组间差异无统计学意史（P〉0．05）；术后24小时和48小时，参麦组患者ALT、AST、LDH水平均低于对照组，差异有统计学意义（P〈0．01）；肝门阻断开放后60min参麦组患者MPO、MDA水平低于对照组，SOD高于对照组，组间差异有统计学意义（P〈0.01）。结论参麦注射液对肝切除手术时肝脏缺血再灌注损伤具有一定保护作用。

Objective To investigate the protective effects of shenmai injection against ischemia-reperfusion injury of liver in hepatectomy. Methods A total of 62 inpatients undergoing elective hepateetomy were enrolled and randomized into shen mai group （n=32） and control group （n=29）. 5%GNS 250ml add shenmai injection 2ml/kg preconditioning 30min before Pringle maneuver for resection in shanmai group, and lasted three days postoperatively, 5%GNS 250ml in control group. Serum Alanine Amino Transferase （ALT）, aspartate aminotransferase （AST） and lactic dehydrogenase （LDH） were determined in 24 and 48 hours postoperatively. The specimen of liver were got before and 60 min after liver blood flow Obstructed, the contents of MPO, SOD and MDA in supernatant of liver were determined by ELISA. Results The Serum levels of ALT,AST,LDH were normal in two groups, and there were no significantly difference between two groups as to the levels of MPO, SOD and MDA. 24 and 48 hours postoperative, the Serum levels of ALT, AST and LDH in shanmai group were lower than control group significantly, and the levels of MPO and MDA in shanmai group were significantly lower than control group too, the levels of SOD were higher in shanmai group than control group. Conclusion Shengmai injection can protect liver from isehemia reperfusion injury in hepatec.tomy.