肝切除时奥曲肽预处理对肝脏缺血再灌注损伤的保护作用

摘要

目的 探讨奥曲肽在肝切除时对肝脏缺血再灌注损伤的保护作用.方法 将30例行肝切除病人随机分为实验组(n=15)和对照组(n=15),肝门阻断前48 h,实验组给予奥曲肽2 μg(kg·6 h)皮下注射,对照组给予生理盐水1 ml/6 h皮下注射预处理;采用Prinsle手法阻断第一肝门,行肝切除术.测定术前及术后第3、7、11天肝功能状况;测定术前及术后1h血浆MDA、TNF-α水平;手术结束时肝组织活检,观察肝组织病理学变化.结果 实验组术后第3,7天ALT、AST水平明显低于对照组(P＜0.01):实验组术后1 h血浆MDA及TNF-α升高明显低于对照组(P＜0.01);实验组肝细胞组织病理学变化轻,术后肝功能复常时间较短.结论 奥曲肽预处理对肝切除时缺血再灌注损伤有保护作用,其机制可能与减少炎性介质产生及抗脂质过氧化有关.%Objective To study the protective effect of Octreotide against ischemia-reperfusion injury when liver was resected Methods Using the routine Pringle's maneuver hepaticvaseular occlusion,thirty patients for resection of liver with cirrhosis were random divided into two groups:octreotide group(n=15)and physiologic saline group(n=15).In octreotide group,the patients with hepatecto15),the patients were injected 1ml saline in the same way.The variations of postoperative liver function were measured.Plasma MDA and TNF-α after reperfusion for 1h were measured and the hepatic histopathologic alterations were also examined.Results The levels of ALT and AST from the octreotide group increased less than those of the physiologic saline group(P＜0.01).Meanwhile,Plasma MDA and TNF-α from the octreotide group was slightly increased(P＜0.01)and the hepatic histopathologic alterations were significantly decreased.Conclusions Given octreotide by subcutaneous injection before blocking portabepatis show all important protective effect against the hepatic isehemia-repedusion injury for resection of liver.