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| 丹参酮Ⅱ_A磺酸钠后处理联合控制性低中心静脉压对肝脏缺血-再灌注损伤的影响 |
| Effects of tanshinone IIA sodium injection post conditioning combined with controlled low central venous pressure on the hepatic ischemia reperfusion injury |
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| DOI： |
| 中文关键词: 肝脏 缺血-再灌注损伤 丹参酮ⅡA磺酸钠 低中心静脉压 |
| 英文关键词: Liver Ischemia-reperfusion injury Tanshinone-ⅡA Low central venous pressure |
| 基金项目:江西省中医药科技项目 (2016A103) |
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| 中文摘要: |
| 目的 探讨丹参酮IIA磺酸钠后处理联合控制性低中心静脉压 (low central venous pressure，LCVP)用于肝脏部分切除术中对肝脏缺血-再灌注 (ischemia-reperfusion，IR)损伤的影响。方法 选择择期行肝脏部分切除手术的患者80例，男46例，女34例，年龄30～65岁，BMI 20～26 kg/m2，ASA Ⅰ或Ⅱ 级。随机分为四组，每组20例。四组均采用静-吸复合全麻，D组采取丹参酮IIA磺酸钠后处理;DL组采取丹参酮IIA磺酸钠后处理联合控制性LCVP (CVP 1～5 cm H2O);L组采取控制性LCVP（CVP 1～5 cm H2O）;C组为对照组，维持CVP在6～12 cm H2O。分别于肝门阻断前10 min (T0)、再灌注后2 h (T1)、6 h (T2)、12 h (T3)和24 h (T4)经颈内静脉采血检测血清NF-κB、细胞黏附分子-1(ICAM-1)、ALT和AST浓度，同时记录MAP、HR和CVP。结果 T0、T1时L组和DL组CVP明显低于C组和D组 (P＜0.01)。与T0时比较，T1～T4时四组NF-κB、ICAM-1、ALT和AST浓度明显升高 (P＜0.01)。与C组比较，T1～T4时DL组、D组和L组ALT、AST、NF-κB和ICAM-1浓度明显降低 (P＜0.05)。T1～T4时D组和L组NF-κB、ICAM-1、ALT和AST浓度明显高于DL组 (P＜0.01)。结论 丹参酮IIA磺酸钠后处理联合控制性LCVP用于肝脏部分切除患者，能减轻肝脏IR损伤的程度。 |
| 英文摘要: |
| Objective To investigate the protective effects of tanshinone-IIA sodium injection post-conditioning combined with controlled low central venous pressure on hepatic ischemia-reperfusion injury during liver resection. Methods Eighty patients scheduled for liver resection, 46 males and 34 females, aged 30-65 years, BMI 20-26 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into four groups: tanshinone-IIA sodium post-conditioning (group D), tanshinone-IIA sodium post-conditioning combined with controlled low central venous pressure (CVP 1-5 cm H2O) group (group DL), controlled low central venous pressure (CVP 1-5 cm H2O) group (group L) and control group (group C) that took the static-compound anesthesia and maintained CVP 6-12 cm H2O, 20 cases in each group. The venous blood samples were drawn from internal carotid vein at different time point: pre-occlusion ten minutes (T0), post-occlusion 2 h (T1), 6 h (T2), 12 h (T3), 24 h after operation (T4), and then detected the levels of NF-κB, intercellular cell adhesion molecule-1 (ICAM-1), ALT and AST. The MAP was detected, HR and CVP were recorded. Results Compared with group C and group D, CVP were significantly lower at T0 and T1 in group L and group DL (P<0.01). Compared with T0, levels of NF-κB, ICAM-1, ALT and AST in four group at T1-T4 were significantly increased (P<0.01). Compared with group C, levels of NF-κB, ICAM-1, ALT and AST in group DL, group L and group D at T1-T4 were significantly decreased (P<0.05). Compared with group DL, levels of NF-κB, ICAM-1, ALT and AST in group D and group L at T1-T4 were significantly increased (P<0.01). Conclusion Tanshinone-IIA sodium injection post-conditioning, combined with controlled low central venous pressure in patients with partial hepatectomy, can reduce the degree of ischemia-reperfusion injury. |
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