术中应用丁二磺酸腺苷蛋氨酸对成人左半肝切除术后残肝功能及再生的影响

The effect of intraoperative administration of S-adenosy.methionine on remnant liver function and regeneration after left lobe resection

目的探讨术中应用丁二磺酸腺苷蛋氨酸（思美泰）对成人左半肝切除术后残肝功能及再生的影响。方法天津市第一中心医院60例左半肝切除患者纳入本研究，随机分为两组，每组30例。在基础治疗相同情况下，实验组术中静脉注射思美泰1000mg治疗，术后两组常规注射思美泰1000mg／d治疗5d。比较术后不同时间点两组患者的ALT、AST、TBiL、IBiL、肝再生率（1iverregenerative ratio，LRR）以及白细胞介素22（interleukin-22，IL-22）的表达变化。结果经术中思美泰预治疗后，实验组肝切除术后肝功能损伤减轻，ALT、AST、TBiL、IBiL指标低于对照组，差异有统计学意义（P〈0．05）；肝再生显著，术后LRR及IL-22的表达显著高于对照组差异有统计学意义（P〈0．05）。结论术中注射丁二磺酸腺苷蛋氨酸预治疗可减轻残肝功能损伤，促进残肝功能的修复及肝脏的再生。

Objective To evaluate the impact of intraoperative administration of S-adenosy- methionine on early remnant liver function and regeneration after left lobe resection. Methods 60 cases undergoing left lobe resection were randomly divided into two groups （30 cases in each group）. While postop therapies were the same. Patients in the experimental group received intraoperatively intravenous injection of S-adenosy-methionine 1 000 rag. Postoperatively the two groups were injected with S-adenosy-methionine 1 000 mg/d daily for successive 5 days. Results Liver function injury was markedly alleviated in experimental group after hepatectomy, Level of ALT, AST, TBiL, IBiL index were lower than the control group, the difference was statistically significant （ P 〈 0. 05 ） ; the LRR and the expression of IL-22 was significantly higher than the control group and the difference was statistically significant （ P 〈 0. 05）, which indicated improved liver regeneration. Conclusion The intraoperative pretreatment of S-adenosy- methionine can reduce the damage of remnant liver function, promote the restoration of remnant liver function and liver regeneration.