Influence of Propofol-remifentanil on Hepatic Ischemia-Reperfusion Injury_West China Medical Journal

Authors：

ZHAO Yu , XUE Qiang

Department of Anesthesia, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P. R. China;

Corresponding author：

Keywords：

肝脏; 缺血再灌注损伤; 丙泊酚; 瑞芬太尼

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目的　探讨丙泊酚-瑞芬太尼对肝脏缺血再灌注损伤的保护作用以及作用机制。方法　2009年6月－2011年12月选择择期需阻断肝门的肝脏手术患者40例，随机分为丙泊酚-瑞芬太尼组（P组）和异氟醚组（I组），每组20例。在术前（T0）和肝门阻断开放后30 min（T1）、60 min（T2）、6 h（T3）、24 h（T4）、72 h（T5）分别抽取动脉血，测定天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和肿瘤坏死因子α（TNF-α）的含量。结果　两组AST、ALT、TNF-α较术前均有增高，差异有统计学意义（P＜0.05）；P组增高幅度明显低于I组，差异有统计学意义（P＜0.05）。结论　丙泊酚-瑞芬太尼对肝脏缺血再灌注损伤具有保护作用，抑制TNF-α的产生可能为其作用机制之一。

Citation： ZHAO Yu,XUE Qiang. Influence of Propofol-remifentanil on Hepatic Ischemia-Reperfusion Injury. West China Medical Journal, 2012, 27(7): 1043-1045. doi: Copy

1.	Vasileiou I, Xanthos T, Koudouna E, et al. Propofol: a review of its non-anaesthetic effects[J]. Eur J Pharmacol, 2009, 605(1-3): 1-8.
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4.	毛惠斌, 曹定睿, 王敬宇. 瑞芬太尼对大鼠肝脏缺血再灌注早期细胞凋亡的影响[J]. 临床医药实践, 2008, 17(6): 416-418.
5.	Zhang Y, Chen ZW, Girwin M, et al. Remifentanil mimics cardioprotective effect of ischemic preconditioning via protein kinase C activation in open chest of rats[J]. Acta Pharmacol Sin, 2005, 26(5): 546-550.
6.	Zhang Y, Irwin MG, Wong TM. Remifentanil preconditioning protects against ischemic injury in the intact rat heart[J]. Anesth Analg, 2004, 101(4): 918-923.
7.	魏勇, 陶国才, 顾健腾, 等. 瑞芬太尼对人肝细胞缺氧复氧损伤的保护作用[J]. 重庆医学, 2007, 36(21): 2191-2192, 2195.
8.	Rogers H 3rd, Zibari GB, Roberts J, et al. Nitric oxide attenuates ischaemia-reperfusion (I/R) injury in the diabetic liver[J]. Clin Transplant, 2004, 18(Suppl 12): 7-11.
9.	Donovan M, Cotter TG. Control of mitochondrial integrity by Bcl-2 family members and caspase-independent cell death[J]. Biochim Biophys Acta, 2004, 1644(2-3): 133-147.
10.	Dejean LM, Martinez-Caballero S, Manon S, et al. Regulation of the mitochondrial apoptosis-induced Channel, Mac, by BCL-2 family proteins[J]. Biochim Biophys Acta, 2006, 1762(2): 191-201.
11.	孙加源, 施梦, 白春学. 缺血再灌注损伤和细胞因子[J]. 国际病理科学与临床杂志, 2006, 26(3): 243-245, 249.
12.	Totsuka E, Fung U, Hakamada K, et al. Analysis of clinical variables of donors and recipients with respect to short-term graft outcome in human liver transplantation[J]. Transplant Proc, 2004, 36(8): 2215-2218.
13.	谭塔林, 王红梅. 肝缺血-再灌注损伤与细胞凋亡[J]. 医学综述, 2006, 12(1): 18-20.

1. 　Vasileiou I, Xanthos T, Koudouna E, et al. Propofol: a review of its non-anaesthetic effects[J]. Eur J Pharmacol, 2009, 605(1-3): 1-8.
2. 　Yoo KY, Yang SY, Lee J, et al. Intracoronary propofol attenuates myocardial but not coronary endothelial dysfunction after brief ischaemia and reperfusion in dogs[J]. Br J Anaesth, 1999, 82(1): 90-96.
3. 　咸云淑, 姜春玲, 郑利民. 异丙酚预处理对大鼠肝缺血再灌注细胞因子的影响及肺损伤的保护作用[J]. 中国实验诊断学, 2010, l4(7): 1002-1005.
4. 　毛惠斌, 曹定睿, 王敬宇. 瑞芬太尼对大鼠肝脏缺血再灌注早期细胞凋亡的影响[J]. 临床医药实践, 2008, 17(6): 416-418.
5. 　Zhang Y, Chen ZW, Girwin M, et al. Remifentanil mimics cardioprotective effect of ischemic preconditioning via protein kinase C activation in open chest of rats[J]. Acta Pharmacol Sin, 2005, 26(5): 546-550.
6. 　Zhang Y, Irwin MG, Wong TM. Remifentanil preconditioning protects against ischemic injury in the intact rat heart[J]. Anesth Analg, 2004, 101(4): 918-923.
7. 　魏勇, 陶国才, 顾健腾, 等. 瑞芬太尼对人肝细胞缺氧复氧损伤的保护作用[J]. 重庆医学, 2007, 36(21): 2191-2192, 2195.
8. 　Rogers H 3rd, Zibari GB, Roberts J, et al. Nitric oxide attenuates ischaemia-reperfusion (I/R) injury in the diabetic liver[J]. Clin Transplant, 2004, 18(Suppl 12): 7-11.
9. 　Donovan M, Cotter TG. Control of mitochondrial integrity by Bcl-2 family members and caspase-independent cell death[J]. Biochim Biophys Acta, 2004, 1644(2-3): 133-147.
10. 　Dejean LM, Martinez-Caballero S, Manon S, et al. Regulation of the mitochondrial apoptosis-induced Channel, Mac, by BCL-2 family proteins[J]. Biochim Biophys Acta, 2006, 1762(2): 191-201.
11. 　孙加源, 施梦, 白春学. 缺血再灌注损伤和细胞因子[J]. 国际病理科学与临床杂志, 2006, 26(3): 243-245, 249.
12. 　Totsuka E, Fung U, Hakamada K, et al. Analysis of clinical variables of donors and recipients with respect to short-term graft outcome in human liver transplantation[J]. Transplant Proc, 2004, 36(8): 2215-2218.
13. 　谭塔林, 王红梅. 肝缺血-再灌注损伤与细胞凋亡[J]. 医学综述, 2006, 12(1): 18-20.

West China Medical Journal

Influence of Propofol-remifentanil on Hepatic Ischemia-Reperfusion Injury

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