血浆微小RNA-122表达与丙泊酚全身麻醉下肝肿瘤切除术后肝损伤相关性研究

Correlation between the expression of plasma microRNA-122 and liver injury induced by liver resection under general anesthesia with propofol

目的评估外周血微小RNA-122（mieroRNA-122，miR-122）表达与丙泊酚全身麻醉下肝肿瘤切除术后肝损伤的相关性。探讨循环血中miR-122可否作为肝肿瘤术后肝损伤的生物标志物。方法筛选于浙江省肿瘤医院择期行肝肿瘤切除术的患者101例。记录患者一般状况、麻醉药物及麻醉方法，记录术中肿瘤大小、手术类型、是否肝门阻断、术中出血量、输血量，记录术后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miR-122浓度。应用统计学分析循环血中miR-122与术后肝损伤的相关性。结果miR-122与ALT值具有良好的相关性，相关系数达0．937（P〈0．05）。miR．122与AST值也有较好的相关性，相关系数为0．764（P〈0．05）。出血量与ALT、AST、miR-122术后升高具有明显相关性（P〈0．05）。有无肝门阻断与AST、miR-122术后升高具有明显相关性（P〈0．05）。结论血浆miR-122表达与丙泊酚全身麻醉下肝肿瘤切除术后肝损伤具有良好相关性。miR-122可能对缺血性肝损伤和创伤性肝损伤较为敏感，有可能作为肝肿瘤切除术后肝损伤的标志物。

Objective To evaluate the relevance between expression of microRNA-122 （miR-122） in peripheral blood and liver injury after liver resection under general anesthesia with propofol, then explore the possibility of miR-122 in plasma as the liver injury biomarkers after liver resection. Methods One hundred and one patients who underwent elective surgery for liver tumors were recruited. The general condition of the patients, narcotic drugs and ways of anesthesia were recorded Intraoperative tumor size, type of surgery, with or without employment of pringle, blood loss and transfusion were recorded. Patients＇ kidney and liver function within 12-24 h after surgery were also recorded. Peripheral blood was taken after the first day after surgery in order to measure the concentration of miR-122. The correlation between circulating miR-122 and postoperative liver injury was judged using the statistical analysis. Results The miR-122 and ALT values has good correlation, correlation coefficient is 0.937 （P〈0.05）. The miR-122 and AST values has good correlation, the correlation coefficient is 0.764（P〈0.05）. The amount of bleeding has a significant correlation with the postoperative increase of ALT, AST, miR-122 （P〈0.05）. With or without portal triad clamping has a significant correlation with the postoperative increase of AST and miR-122 （P〈0.05）. Conclusions The expression of miR-122 in plasma has a good correlation with liver injury that was induced by liver cancer resection under general anesthesia with propofol. The miR-122 may be more sensitive to ischemic liver injury and trauma-induced liver injury, it can be used as marker of liver injury after liver tumor resection.