比较异丙酚预处理及后处理对肝缺血再灌注损伤保护作用

Comparison between the protective effect of Propofol ischemia pretreatment and ischemia postconditioning in hepatic ischemia-reperfusion injury

目的比较异丙酚预处理及后处理对肝脏缺血再灌注损伤的保护作用。方法 60例拟行肝叶切除术的肝癌患者,随机均分为3组:对照组(I组),异丙酚预处理组(II组)和异丙酚后处理组(III组)。于麻醉前(T1)、肝门阻断前(T2)、肝门阻断15 m in(T3)、肝门开放10 m in(T4)、30 m in(T5)、60 m in(T6)和90 m in(T7)等时点抽血测谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(G G T)、总胆红素(TBIL)、超氧化物歧化酶(SO D)活性及丙二醛(M D A)的含量。结果①3组AST、ALT在T3、T4、T5、T6、T7时点逐渐增高,与T1比较差异有显著性(P<0.05),在T4、T5、T6、T7时点II组、III组与I组比较有显著性差异(P<0.05),但II组与III组比较无显著性(P>0.05)。②在T4、T5、T6、T7时点,I组SO D的活性减弱、M D A的含量增加,而II组、III组SO D的活性增加、M D A的含量减少;3组SO D、M D A与T1比较均差异有显著性(P<0.05￣0.01),II组、III组与I组比较有显著性差异(P<0.05),而II组与III组比较无显著性(P>0.05)。结论异丙酚预处理及后处理对肝脏缺血再灌注损伤均有保护作用,两者效能相近。

【Objective】 To compare the protective effect between Propofol pretreatment and postconditioning in hepatic ischemia-reperfusion injury（I/R）.【Method】 Sixty hepatoma patients undergoing hepatolobectomy divided into two groups（n =20）： control group（I）,and Propofol postconditing group（II） and Propofol postconditing group（III）.Blood samples were taken suction to detect AST,ALT,GGT,TBIL,SOD and MDA concentration at the time point as following： before anesthesia（T1）,before porta hepatic blockage（T2）,15 min after porta hepatic blockage（T3） and 10 min（T4）,30 min（T5）,60 min（T6）,90 min（T7） after porta hepatic open.【Results】 Compared with T1,the plasma concentration of AST and ALT of those patients in the there groups were increased at T3,T4,T5,T6,T7.Compared with that in I group,the plasma concentrations of AST and ALT of those in II and III groups at T4 T5,T6 and T7 showed significantly raise.However,there was no difference between II and III groups.The activity of SOD in I group decreased as well as MDA increased at T4,T5,T6,T7.However,the former increased as well as the later decreased at T4,T5,T6,T7 in II and III groups.Compared with T1,there were significant differences in I,II and III groups（P 0.05～0.01）.Compared with I group,there were significant differences in II and III groups（P 0.05）,however,there were no difference between II and III groups（P 0.05）.【Conclusions】 Propofol pretreatment and postconditioning have equivalent protective effect in hepatic ischemia-reperfusion injury（I/R）.