口服富氢液对肝癌射频消融术患者围术期血浆细胞因子的影响

摘要

目的：探讨口服富氢液对肝癌射频消融术患者围术期血浆细胞因子的影响。方法：原发性肝癌患者100例，ASAⅠ－Ⅱ级，男73例，女27例，年龄38～75岁，体重（45～78）kg。随机分为对照组（C 组）和富氢液组（H 组），每组50例，择期行超声引导下经皮肝穿刺肝癌射频消融术。H 组患者于术前4h 口服富氢液5ml／kg，而 C 组患者于术前4h 口服等量的无氢对照液。分别于麻醉诱导前（T0）、手术开始时（T1）、手术结束时（T2）及术后24h（T3），采集静脉血，应用酶联免疫吸附（ELISA）方法测定血浆 IL －4、IL －10、HMGB1及 VEGF－1浓度。结果：T0、T1、T2及 T3时间点，H 组与 C 组患者血浆中细胞因子 IL －4、IL －10、HMGB1和 VEGF －1的浓度分别随时间升高，T3时间点血浆中细胞因子浓度达到释放高峰。在 T2及 T3时间点，与 C 组比较，H组 IL －4及 IL －10升高，HMGB1和 VEGF －1的浓度降低，具有统计学意义（P ＜0．05）。T0及 T1时间点，C组和 H 组患者血浆中 IL －4、IL －10、HMGB1和 VEGF －1浓度差异无统计学意义（P ＞0．05）。结论：术前口服富氢液可有效改善肝癌患者围术期血浆炎症因 IL －4、IL －10、HMGB1、VEGF －1的生成，从而提高肿瘤患者的抗炎能力。%Objective:To investigate the effects of hydrogen -rich water on plasma cytokines in liver cancer pa-tients during perioperative period.Methods:One -hundred ASAⅠ -Ⅱpatients underwent the operation of radiofre-quency ablation of liver cancer,with 73 male and 27 female which were 38 ~75 years old,were randomly assigned to two groups:Control group (group C)and hydrogen -rich water group (group H),50 patients of each group undergo-ing elective percutaneous liver puncture radiofrequency ablation of liver cancer with ultrasound.In group H,the pa-tients drank 5ml/kg hydrogen -rich water at 4h before operation,while the patients drank the same dose of control water in group C.Blood samples were collected from peripheral vein before anesthesia (T0),at the beginning of oper-ation (T1),at the end of operation (T2)and 24h after operation (T3)for determination of serum concentrations of IL -4,IL -10,HMGB1 and VEGF -1 using ELISA.Results:At T0,T1,T2 and T3 time points,the concentration of IL -4,IL -10,HMGB1 and VEGF -1 were increased with time,and the peak concentration at T3 in the C and H groups.Compared with group C,at T2 and T3,IL -4 and IL -10 levels were significantly elevated.HMGB1 and VEGF -1 were significantly reduced in group H (P <0.05).At T0 and T1,IL -4,IL -10,HMGB1 and VEGF -1 had no significant difference between the two groups C and H (P >0.05).Conclusion:Hydrogen -rich water signifi-cantly improves the release of IL -4,IL -10,HMGB1 and VEGF -1 during perioperative period of liver cancer sur-gery,and improves the anti -inflammatory ability in cancer patients.