目的 探討丙泊酚-瑞芬太尼對(duì)肝臟缺血再灌注損傷的保護(hù)作用以及作用機(jī)制。 方法 2009年6月－2011年12月選擇擇期需阻斷肝門的肝臟手術(shù)患者40例，隨機(jī)分為丙泊酚-瑞芬太尼組（P組）和異氟醚組（I組），每組20例。在術(shù)前（T0）和肝門阻斷開放后30 min（T1）、60 min（T2）、6 h（T3）、24 h（T4）、72 h（T5）分別抽取動(dòng)脈血，測(cè)定天冬氨酸氨基轉(zhuǎn)移酶（AST）、丙氨酸氨基轉(zhuǎn)移酶（ALT）和腫瘤壞死因子α（TNF-α）的含量。 結(jié)果 兩組AST、ALT、TNF-α較術(shù)前均有增高，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；P組增高幅度明顯低于I組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 結(jié)論 丙泊酚-瑞芬太尼對(duì)肝臟缺血再灌注損傷具有保護(hù)作用，抑制TNF-α的產(chǎn)生可能為其作用機(jī)制之一。
引用本文： 趙宇,薛強(qiáng). 丙泊酚-瑞芬太尼對(duì)肝臟缺血再灌注損傷的影響. 華西醫(yī)學(xué), 2012, 27(7): 1043-1045. doi: 復(fù)制
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| 10. | Dejean LM, Martinez-Caballero S, Manon S, et al. Regulation of the mitochondrial apoptosis-induced Channel, Mac, by BCL-2 family proteins[J]. Biochim Biophys Acta, 2006, 1762(2): 191-201. |
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| 12. | Totsuka E, Fung U, Hakamada K, et al. Analysis of clinical variables of donors and recipients with respect to short-term graft outcome in human liver transplantation[J]. Transplant Proc, 2004, 36(8): 2215-2218. |
| 13. | 譚塔林, 王紅梅. 肝缺血-再灌注損傷與細(xì)胞凋亡[J]. 醫(yī)學(xué)綜述, 2006, 12(1): 18-20. |
- 1. Vasileiou I, Xanthos T, Koudouna E, et al. Propofol: a review of its non-anaesthetic effects[J]. Eur J Pharmacol, 2009, 605(1-3): 1-8.
- 2. Yoo KY, Yang SY, Lee J, et al. Intracoronary propofol attenuates myocardial but not coronary endothelial dysfunction after brief ischaemia and reperfusion in dogs[J]. Br J Anaesth, 1999, 82(1): 90-96.
- 3. 咸云淑, 姜春玲, 鄭利民. 異丙酚預(yù)處理對(duì)大鼠肝缺血再灌注細(xì)胞因子的影響及肺損傷的保護(hù)作用[J]. 中國(guó)實(shí)驗(yàn)診斷學(xué), 2010, l4(7): 1002-1005.
- 4. 毛惠斌, 曹定睿, 王敬宇. 瑞芬太尼對(duì)大鼠肝臟缺血再灌注早期細(xì)胞凋亡的影響[J]. 臨床醫(yī)藥實(shí)踐, 2008, 17(6): 416-418.
- 5. Zhang Y, Chen ZW, Girwin M, et al. Remifentanil mimics cardioprotective effect of ischemic preconditioning via protein kinase C activation in open chest of rats[J]. Acta Pharmacol Sin, 2005, 26(5): 546-550.
- 6. Zhang Y, Irwin MG, Wong TM. Remifentanil preconditioning protects against ischemic injury in the intact rat heart[J]. Anesth Analg, 2004, 101(4): 918-923.
- 7. 魏勇, 陶國(guó)才, 顧健騰, 等. 瑞芬太尼對(duì)人肝細(xì)胞缺氧復(fù)氧損傷的保護(hù)作用[J]. 重慶醫(yī)學(xué), 2007, 36(21): 2191-2192, 2195.
- 8. Rogers H 3rd, Zibari GB, Roberts J, et al. Nitric oxide attenuates ischaemia-reperfusion (I/R) injury in the diabetic liver[J]. Clin Transplant, 2004, 18(Suppl 12): 7-11.
- 9. Donovan M, Cotter TG. Control of mitochondrial integrity by Bcl-2 family members and caspase-independent cell death[J]. Biochim Biophys Acta, 2004, 1644(2-3): 133-147.
- 10. Dejean LM, Martinez-Caballero S, Manon S, et al. Regulation of the mitochondrial apoptosis-induced Channel, Mac, by BCL-2 family proteins[J]. Biochim Biophys Acta, 2006, 1762(2): 191-201.
- 11. 孫加源, 施夢(mèng), 白春學(xué). 缺血再灌注損傷和細(xì)胞因子[J]. 國(guó)際病理科學(xué)與臨床雜志, 2006, 26(3): 243-245, 249.
- 12. Totsuka E, Fung U, Hakamada K, et al. Analysis of clinical variables of donors and recipients with respect to short-term graft outcome in human liver transplantation[J]. Transplant Proc, 2004, 36(8): 2215-2218.
- 13. 譚塔林, 王紅梅. 肝缺血-再灌注損傷與細(xì)胞凋亡[J]. 醫(yī)學(xué)綜述, 2006, 12(1): 18-20.