血浆miR-192表达与丙泊酚全麻下肝脏肿瘤切除术肝损伤相关性研究

Correlation between plasma miR-192 expression and liver injury after liver resection under general anesthesia with propofol

目的评估外周血mi R-192表达与丙泊酚全麻下肝脏肿瘤切除术肝损伤的相关性,探讨循环血中mi R-192可否作为肝脏肿瘤术后肝损伤的生物标志物。方法选取行肝脏肿瘤择期手术的患者101例,记录患者一般状况、麻醉药物及麻醉方法,肿瘤大小、手术类型、是否肝门阻断、术中出血量,术后12~24h内患者的肝肾功能。术后第1天取外周血测定循环血中mi R-192浓度。应用统计学方法分析循环血中mi R-192水平与手术肝损伤的相关性。结果术中出血量≥500ml的患者,术后ALT、AST、mi R-192升高幅度显著高于出血量<500ml的患者,差异有统计学意义(P=0.046、0.020、0.000)。有肝门阻断的患者,术后mi R-192升高幅度显著高于无肝门阻断患者,差异有统计学意义(P=0.001)。mi R-192与ALT、AST均呈正相关(r=0.930、0.744,P=0.000、0.000)。术中丙泊酚用量与术后ALT、AST、mi R-192均呈正相关(r=0.231、0.248、0.232,P=0.020、0.012、0.020)。手术持续时间与术后ALT、AST、mi R-192均呈正相关(r=0.184、0.241、0.185,P=0.011、0.001、0.011)。结论血浆mi R-192表达与丙泊酚全麻下肝脏肿瘤切除术肝损伤具有良好的相关性,mi R-192可能对缺血性肝损伤和创伤性肝损伤较为敏感,可以作为肝脏肿瘤切除术肝损伤的标志物。

Objective To evaluate the relationship between miR-192 expression and hepatic injury after liver tumor resection under general anesthesia with propofol.Methods One hundred and one patients who underwent elective liver tumor resection were enrolled in the study.The general condition,anesthetic drugs,anesthesia methods,tumor size,operation type,portal triad clamping,intraoperative blood loss were recorded.The liver and kidney functions of the patients were measured 12-24 hours after operation.The concentration of miR-192 in peripheral blood was measured on the first day after operation.The correlation between miR-192 in circulating blood and postoperative liver injury was analyzed.Results Postoperative ALT,AST,miR-192 levels was significantly higher in patients with intraoperative blood loss ≥500ml than those in patients with blood loss 〈500ml（P = 0.046,0.020,0.000）.There was a significant increase in the postoperative miR-192 level in patients with hilar interruption compared with those without hilar interruption（P = 0.001）.Mi R-192 was positively correlated with ALT and AST（r = 0.930,0.744,P = 0.000,0.000）.The dosage of propofol was positively correlated with ALT,AST and miR-192（r = 0.231,0.248,0.232,P = 0.020,0.012,0.020）.The duration of operation was positively correlated with ALT,AST and miR-192（r = 0.184,0.241,0.185,P = 0.011,0.001,0.011）.Conclusion This study shows that the expression of miR-192 in plasma has a good correlation with liver injury after liver tumor resection under general anesthesia with propofol.Mi R-192 may be sensitive to ischemic liver injury and traumatic liver injury and may be used as a postoperative marker of liver injury after liver tumor resection.