抑肽酶对肝移植患者围术期细胞因子的影响  

Effects of aprotinin on plasma inflammatory cytokines during orthotopic liver transplantation

作　　者：李勇[1] 崔苏扬[2] 靳艳卿[1] 李榕[1] 周路阳[1] 顾小萍[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008 [2]南京中医药大学附属医院麻醉科

出　　处：《江苏医药》2008年第7期652-654,共3页Jiangsu Medical Journal

基　　金：江苏省科技厅资助项目(BS2003001)

摘　　要：目的探讨抑肽酶对肝移植患者围术期细胞因子的影响。方法40例行原位肝移植(OLT)术晚期肝病患者随机分为两组:抑肽酶组20例(A组);对照组20例(C组)。A组首量1×106KIU,持续量0.25×106KIU/h持续静脉泵注抑肽酶,直至术毕;C组泵注等量生理盐水。于术前(T1)、无肝前5min(T2)、新肝5min(T3)、新肝30min(T4)和新肝120min(T5)5个时间点采集颈内静脉血比较两组血浆肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10的水平变化。结果与术前相比,在无肝前期和新肝期C组血中上述指标浓度较术前显著升高(P<0.05);但A组未见明显变化。结论肝移植手术由于缺血再灌注及手术应激,体内发生了急性炎性反应及抗炎反应;抑肽酶能减轻此类手术中的急性炎性反应,对肝脏具有保护效应。Objective To investigate the effects of aprotinin on plasma cytokines during orthotropic liver transplantation（OLT）. Methods Forty patients with end-stage liver diseases, childpugh grade C, undergoing OLT were randomly divided into two groups with 20 cases each. Group AP received continuously aprotinin intravenous infusion during operation and group C received the same amount of normal saline instead of AP. Internal jugular vein blood samples were collected to measure plasma concentration of tumor necrosis （TNF）-α, interleukin （IL）-6, and IL-10 before skin incision （T1）, at 5 rain before anhepatic phase（T2）, 5 rain（T3）, 30 min（T4）and 120 rain（T5） after reperfusion phase. Results The plasma levels of TNF-α, IL-6, IL-10 were significantly increased at T4 and kept high levels at the following times in group C（P〈0. 05）, which were not significantly changed in group A. Conclusion Acute inflammatory actions were observed during OLT, especially in the reperfusion phase. Aprotinin has a protective effect on the liver by reducing OLT-induced acute inflammatory actions.

关 键 词：抑肽酶 肝移植 细胞因子 

分 类 号：R969[医药卫生—药理学]