摘要
目的：探讨肢体远隔缺血预处理对肝脏手术中血清 TNF-α和 HMGB1水平的影响。方法60例择期行肝部分切除手术的患者,ASA Ⅰ或Ⅱ级,随机分成两组：RIPC 组（R 组）接受右上肢缺血预处理,对照组（C 组）不进行预处理。分别于肝脏缺血前10 min（T0）、再灌注后1 h（T1）、6 h （T2）、24 h（T3）、48 h（T4）经中心静脉导管采集血样测定 TNF-α、高迁移率族蛋白 B1（HMGB1）及谷草转氨酶（AST）、谷丙转氨酶（ALT）水平。结果与 T0比较,T1~T4时两组血清 TNF-α、HMGB1及 AST、ALT 水平均明显升高（P 〈0.05）。与 C 组比较,T1~T4时 R 组 TNF-α、HMGB1及 AST、ALT 水平均明显降低（P 〈0.05）。结论肢体远隔缺血预处理用于肝脏部分切除术中,能够减轻肝脏缺血-再灌注损伤程度,可能与缓解肝脏缺血-再灌注时血清 TNF-α、HMGB1的释放,减轻全身炎症反应有关。
Objective To investigate the effect of limb remote ischemic preconditioning on lev-els of serum TNF-αand HMGB1 in liver operation.Methods Sixty patients,ASA Ⅰ or Ⅱ,undergo-ing selective partial liver resection were randomly divided into two groups：RIPC group （group R）re-ceived the right upper limb ischemic preconditioning,Control group （group C）without pretreatment. The blood samples were collected from the venous catheter at the following time points：10 minutes before liver ischemia （T0 ）,1 h （T1 ）,6 h （T2 ）,24 h （T3 ）,48 h （T4 ）after reperfusion respectively;and then the tumor necrosis factor-α（TNF-α）,high mobility group protein B1 （HMGB1）,glutamic oxalacetic transaminase （AST）and glutamic-pyruvic transaminase （ALT）levels were measured. Results Compared with T0 ,the serum levels of TNF-α,HMGB1 and AST,ALT were significantly higher at T1-T4 in both groups （P 〈 0.05 ）;Compared with group C,the serum levels of TNF-α, HMGB1 and AST,ALT at T1-T4 in group R were significantly lower （P 〈0.05）.Conclusion Limb remote ischemic preconditioning applied for partial liver resection can reduce the degree of liver ische-mia-reperfusion injury,which might be related to the reduction of the systemic inflammatory response during liver ischemia-reperfusion through alleviating the TNF-αand HMGB1 release in serum.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第12期1193-1195,共3页
Journal of Clinical Anesthesiology
关键词
肝脏
缺血-再灌注损伤
肢体远隔缺血预处理
Liver
Ischemia-reperfusion injury
Limb remote ischemic preconditioning
