Iwatsuki N, Yasuda A, Tokutomi S, Saishu T, Koga Y, Hashimoto Y
Department of Anesthesiology, Tohoku University School of Medicine, Sendai, Japan.
J Anesth. 1992 Apr;6(2):131-7. doi: 10.1007/s0054020060131.
The efficacy of a low dose of PGE(1)-use on the postoperative liver damage was evaluated. PGE(1) was infused in with the mean rate of 0.026 microg.kg(-1).min(-1) during surgical procedure to 93 patients under GO-enflurane anesthesia (the PG). Serum GOT, GPT and total bilirubin (TBIL) values measured before, at the end of (End) and 3 days (3d) after the operation were compared to those obtained from 43 patients without PGE(1) administration (the control). This dose of PGE(1) did not change blood pressure and heart rate, but slightly decreased Pa(O)(2). In patients with preoperative normal values of GOT, GPT and TBIL, increases in GOT, GPT and TBIL observed at End in the PG were significantly lower than those in the control (31.9 vs 72.2 IU, 25.9 vs 61.9 IU, 0.68 vs 0.83 mg.dl(-1), respectively). GOT, GPT and TBIL at 3d significantly increased in both groups, and these levels were identical between the two groups. In patients with preoperative abnormal values, only GOT at End increased in both groups, while no significant difference between the PG and the control group was noted. GOT at 3d and GPT at End and 3d did not significantly changed in either group. These results suggest that the low dose of PGE(1) administered during an operation prevents the development of postoperative liver damage, but does not treat the damaged hepatic cells.
评估了低剂量使用前列腺素E1(PGE1)对术后肝损伤的疗效。在手术过程中,以平均速率0.026微克·千克-1·分钟-1给93例接受恩氟烷麻醉的患者输注PGE1(PG组)。将术前、手术结束时(End)和术后3天(3d)测得的血清谷草转氨酶(GOT)、谷丙转氨酶(GPT)和总胆红素(TBIL)值与43例未给予PGE1的患者(对照组)的结果进行比较。该剂量的PGE1未改变血压和心率,但使动脉血氧分压(PaO2)略有下降。术前GOT、GPT和TBIL值正常的患者,PG组End时GOT、GPT和TBIL的升高明显低于对照组(分别为31.9对72.2国际单位、25.9对61.9国际单位、0.68对0.83毫克·分升-1)。两组术后3d时GOT、GPT和TBIL均显著升高,且两组间这些水平相同。术前值异常的患者,两组End时仅GOT升高,而PG组与对照组之间无显著差异。两组术后3d时的GOT以及End和3d时的GPT均无显著变化。这些结果表明,手术期间给予低剂量的PGE1可预防术后肝损伤的发生,但不能治疗受损的肝细胞。