异搏定对人肝脏缺血再灌注损伤保护作用的初步观察  

Protective Effects of Verapamil on Ischemia-Reperfusion Injury for Resection of Human Liver

作　　者：杨勇[1] 杨汉新[1] 严修源[1] 杨敏[1] 刘吉奎[2] 

机构地区：[1]成都市第一人民医院,四川成都610016 [2]第三军医大学西南医院全军肝胆外科研究所,重庆400038

出　　处：《成都医药》2003年第1期3-5,共3页

摘　　要：目的 :探讨异搏定在临床肝叶切除时对肝脏缺血再灌注损伤的保护作用。方法 :将 4 0例患有肝脏占位病变的肝叶切除患者随机分为对照组 (n =2 0 )和实验组 (n =2 0 ) ,分别在肝门阻断前经胃网膜右静脉注入 2 0mL生理盐水和异搏定 5mg加生理盐水 2 0mL预处理 ;肝叶切除时用Pringle手法阻断第一肝门 15～ 17min ,再灌注 1h后检测肝细胞内游离钙 ([Ca2 +]i)、肝组织学变化 ,测定术后动脉血酮体比值 (AKBR)、肝功能恢复情况。结果 :异搏定预处理组在缺血再灌注后谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、 [Ca2 +]i升高不明显 ,明显低于对照组 (P <0 0 1) ,组织学的改变明显较轻 ,术后肝功能复常时间较短 ,有效保护了肝脏储备功能。结论 :异搏定预处理对临床肝叶切除时的缺血再灌注损伤有明显保护作用 。Objective:To study the protective effect of calcium block agents,verapamil against ischemia-reperfusion injury of human liver.Methods:Fourty patients for lobe/section hepatectomy were randomly divided into two groups.Verapamil group(test group),the 20 patients with lobe hepatectomy were given 5mg verapamil in 20mL saline by right gastroepiploic vein before blocking portra hepatis.Physiologic saline group(control group),were injected 20mL saline only in the same way.The routine Pringle's maneuver hepatic vascular occlusion in 15～17 min.Liver intracellular[Ca 2+ ]i after being reperfused for 1 h were measured as well as the hepatic histopathologic alterlations were also examined.The variation of postoperative liver function and arterial ketone body ratio were measured.Results:The levels of free calcium ions in the hepatic cell and serum enzyme from the test group increased not more significantly than those of the control group.The degree of hepatic pathological injury was lower and the hepatic function restored earlier in verapamil group.Conclusion:Given verapamil by hepatic portal vein before blocking porta hepatis,which shows and important protective effect against hepatic ischemia-reperfusion injury for resection of liver and have benefit for recovery of patients.

关 键 词：肝脏 缺血再灌注损伤 异搏定 细胞内钙 动脉血酮体比值 

分 类 号：R972[医药卫生—药品]