| 摘要: |
| 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＋PGE，20μg／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—PGE，20ug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〉005）。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PGE，干预引起的变化，C组均较B组明显。结论PGE，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。 |
| 关键词: 肝切除术前列腺素E1肝功能 |
| DOI： |
| 分类号:R657.45 |
| 基金项目:浙江省科技厅立项课题（2009C33130） |
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| Protective effect of prostaglandin E1 on liver function in patients following hepatectomy |
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YAN Oiuliang, ZHU Yougen, LIU Dong, et al. Department of Hepatobiliary Surgery, Jinhua People＇s Hospital, Jinhua 321000, China
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| Abstract: |
| 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 20 tJ g/d Lipo-PGE1 for 14d, n=40） and group C （undergoing portal vein infusion of 20 μ g 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-, IL-6, IL-10 and IFN-γ in 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 All parameters among the three groups had no significant differences before surgery （all P 〉0.05）. The levels of TNF-co, IL-6 and IL-10 in all groups were markedly increased after surgery and then returned to baseline gradually, while these cytokines in groups B and C were increased significantly less and decreased shorter than those in group A （all P〈0.05）. The pre- and postoperative IFN- γ levels 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 （all 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 （all P〈0.05）. All the changes caused by PGE1 intervention were more evident in group C than those in group B. Conclusion PGE~ 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. |
| Key words: Hepatectomy PGE1 Liver function |
