门静脉注射异丙酚对家兔肝脏缺血再灌注损伤的保护作用  

Protective effect of propofol delivered through portal vein on hepatic ischemia reperfusion injury in rabbits

作　　者：周党军 吕毅[2] 安东均 罗遥[3] 张成 

机构地区：[1]陕西省咸阳市中心医院肝胆外科,陕西咸阳712000 [2]西安交通大学医学院第一附属医院肝胆外科,陕西西安710061 [3]西安交通大学医学院第一附属医院麻醉科,陕西西安710061

出　　处：《中国普通外科杂志》2008年第7期654-657,共4页China Journal of General Surgery

摘　　要：目的探讨麻醉药物异丙酚经门静脉给药对肝脏缺血再灌注(I/R)损伤的保护作用及其可能机制。方法将动物随机分为4组,每组8只。A组为假手术组,仅开关腹;B组为单纯阻断入肝血流30min再灌注60min(I/R)组;C组为I/R组(颈静脉注射异丙酚组;D组为I/R组(门静脉注射异丙酚组;。检测各组家兔血清ALT和AST、肝组织及血液中内皮素-1(ET-1)和一氧化氮(NO)以及肝组织中ATP含量。结果门静脉注射异丙酚可降低I/R期间血清ALT,AST及肝组织和血液中ET-1,提高肝组织和血液中NO及肝组织中ATP含量,其对肝I/R损伤的保护效应优于颈静脉给药。结论经门静脉注射异丙酚对肝脏I/R损伤有明显的保护作用,此作用可能是通过调节ET-1与NO浓度的失衡及提高肝组织中ATP含量而实现的。Objective To explore the protective effect of portal vein administration of propofol on hepatic ischemia reperfusion injury （HIRI） and its mechanism. Methods Thirty-two male rabbits were randomly allocated into four groups ： Group A （ sham operation group ） , the abdomen was only opened and closed ; group B, the hepatic inflow was occluded for 30 min, and reperfused for 60 min ; group C, the same managment as group B ＋ propofol injected through jugular vein; group D, the treatment same as group B ＋ propofol injected through portal vein. Drug injection was completed 20 min before hepatic inflow occlusion. Serum ALT and AST, and endothelin-1 （ET-1 ） and nitric oxide （NO）in the hepatic tissue and blood, and the content of ATP in hepatic tissue were determined. Results The level of ET-1 in plasma and hepatic tissue was significantly increased in. group B compared to group C and D （P 〈0.01 ,P 〈0.05）. The level of NO in serum and hepatic tissue in group B was significantly lower than that in group C, D （ P 〈 0. 01 ）. The content of ATP in hepatic tissue was significantly decreased in group B compared to group C and D （ P 〈 0.01 ）. Comparing the efficiency of administration routes, propofol delivered through portal vein have better protective effect on HIRI. Conclusions Propofol delivered through portal vein has significant protective effect on HIRI. Propofol may adjust disbalance between ET-1 and NO to improve microcirculation, and elevate the content of ATP in the hepatic tissue. All of these contribute to protective effect on HIRI.

关 键 词：肝/血液供给 缺血再灌注损伤 异丙酚 内皮素-1 一氧化氮 三磷酸腺苷 

分 类 号：R364.2[医药卫生—病理学]