异甘草酸镁对肝癌病人肝切除术后肝脏缺血再灌注损伤的影响

Effect of magnesium isoglycyrrhizinate on hepatic ischemia reperfusion injury after hepatectomy in patients with hepatocellular carcinoma

目的探讨异甘草酸镁对肝癌病人肝切除术后肝脏缺血再灌注损伤的影响。方法选取2016年1月至2018年1月宜宾市第一人民医院普外科收治的80例行开腹肝切除术并在术中采用Pringle法行全肝门阻断的肝癌病人作为研究对象,将其按随机数字表法分为观察组和对照组,每组各40例。对照组于术后静脉滴注还原型谷胱甘肽;观察组在对照组基础上加用异甘草酸镁静脉滴注。观察术前及术后1 d、3 d肝功能指标、氧化应激指标及炎性细胞因子水平。结果术后1 d及术后3 d,观察组丙氨酸转氨酶、天冬氨酸转氨酶、血总胆红素水平均低于对照组(均P<0.05),两组血清白蛋白水平差异无统计学意义(P>0.05);观察组血浆丙二醛水平低于对照组,超氧化物歧化酶水平高于对照组(P<0.05);观察组肿瘤坏死因子α、白细胞介素6水平低于对照组,白细胞介素10水平高于对照组(P<0.05)。结论对肝癌病人肝切除术后予以异甘草酸镁治疗可减少促炎细胞因子的产生,减轻氧化应激反应,对肝脏缺血再灌注损伤具有保护作用。

Objective To explore the effect of magnesium isoglycyrrhizinate on hepatic ischemia reperfusion injury after hepatectomy in patients with hepatocellular carcinoma.Methods Eighty patients with hepatocellular carcinoma who underwent open hepatectomy and total hepatic portal blocking with Pringle method from January 2016 to January 2018 in the General Surgery Department of Yibin First People's Hospital were selected as research objects.The patients were randomly divided into the observation group and the control group,40 cases in each group.Both control group and observation were intravenously injected with reduced glutathione.The observation group was given intravenous infusion of magnesium isoglycyrrhizinate additionally.The liver function,and levels of oxidative stress and inflammatory factors were observed before and 1 day and 3 days after operation.Results One day and 3 days after operation,the levels of ALT,AST and TBIL in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the level of ALB between the two groups(P >0.05).The level of MDA was significantly lower,and the level of SOD was significantly higher in the observation group than in the control group(P<0.05).The levels of TNF-αand IL-6 were significantly lower,and the IL-10 level was significantly higher in the observation group than in the control group(P<0.05).Conclusion Magnesium isoglycyrrhizinate treatment can reduce the production of proinflammatory factors,alleviate oxidative stress,and protect the liver from ischemia-reperfusion injury in patients with hepatocellular carcinoma after hepatectomy.