首页> 中文期刊> 《浙江医学》 >前列腺素E1对肝切除术后肝功能的保护作用

前列腺素E1对肝切除术后肝功能的保护作用

         

摘要

Objective To investigate the protective effect of prostaglandin E1 (PGE1) on liver function in patients after hep-atectomy. Methods One hundred and eighteen patients scheduled to undergo major liver resection were randomly designated to group A(receiving conventional postoperative treatment n=36), group B (receiving conventional treatment plus intravenous in-jection of 20μg/d Lipo- PGE1 for 14d, n=40) and group C (undergoing portal vein infusion of 20μg Lipo- PGE1 immediately after portal vein clamping was finished during surgery plus the same regimen as group B, n=42). The levels of alanine transaminase (ALT) and cytokines TNF- α, IL- 6, IL- 10 and IFN- γin peripheral blood were measured before and 1, 3, 5, 9, 14 and 28 d after surgery, and the portal venous flow volume was also determined before and 1, 7 and 24 d after surgery. Results Al parameters among the three groups had no significant differences before surgery (al P>0.05). The levels of TNF- α, IL- 6 and IL- 10 in all groups were markedly increased after surgery and then returned to baseline gradual y, while these cytokines in groups B and C were increased significantly less and decreased shorter than those in group A (al P<0.05). The pre- and postoperative IFN- γlevels in group A showed no significant changes, but those in groups B and C were significantly increased and continued to rise until 28 d after surgery (al P<0.05).No difference was observed in portal venous flow volume before and after surgery in group A, while a continuous increase was found after surgery in groups B and C (al P<0.05). All the changes caused by PGE1 intervention were more evident in group C than those in group B. Conclusion PGE1 is beneficial for early recovery of liver function after hep-atectomy, which may be related to regulating cytokines levels and increasing the portal venous inflow.%目的:探讨前列腺素E1(PGE1)对肝切除术后肝功能的保护作用及机制。方法选取118例接受肝大部切除术患者,其中A组36例(术后常规治疗),B组40例(术后常规治疗+PGE120μg/d,静脉注射,连续14d),C组42例(术中门静脉阻断再开放时行Lipo- PGE120μg门静脉灌注+B组方案)。分别检测3组患者术前与术后1、3、5、9、14、28d外周血ALT及TNF-α、IL-6、IL-10、IFN-γ水平,以及术前与术后1、7、28d门静脉血流量的变化。结果3组患者术前各指标差异均无统计学意义(均P>0.05)。术后各组患者ALT、TNF-α、IL-6、IL-10水平均明显升高,然后逐渐恢复,但B、C组升高幅度明显低于A组(均P<0.01),且恢复时间快于A组;A组IFN-γ水平在手术前后无明显改变,但B、C组在术后28d,IFN-γ水平明显持续升高(均P<0.01)。A组门静脉血流量手术前后无明显改变,而B、C组术后门静脉血流量在观察时段内明显且逐渐增高(均P<0.05)。以上所有PGE1干预引起的变化,C组均较B组明显。结论 PGE1有利于肝切除术后早期功能的恢复,其作用机制可能与调节细胞因子水平及增加门静脉血流有关。

著录项

相似文献

  • 中文文献
  • 外文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号