Wang Yongsheng, Qiu Rongen, Kong Gaoyin, Liu Jitong
Department of Anesthesiology, Hunan Provincial People's Hospital, Changsha, Hunan 410005, P.R. China.
Department of Anesthesiology, Xiangtan Central Hospital, Xiangtan, Hunan 411413, P.R. China.
Exp Ther Med. 2019 May;17(5):3694-3700. doi: 10.3892/etm.2019.7367. Epub 2019 Mar 8.
The effects of propofol combined with remifentanil on the nitric oxide (NO), endothelin (ET-1) and inflammatory cytokines in the plasma of patients with liver cirrhosis were investigated. A retrospective analysis of 68 patients with liver cirrhosis who underwent hepatectomy in the Hunan Provincial People's Hospital from March 2016 to July 2018 was made. According to different anesthesia methods, 30 patients anesthetized with propofol were enrolled into Group A. The other 38 patients anesthetized with propofol combined with remifentanil were enrolled into Group B, and the operation time, amount of bleeding during operation and postoperative awake time of the two groups were recorded. At three separate time-points T (30 min before the anesthesia), T (after the portal triad clamping), T (3 days after the operation), aspartate transaminase (AST) and alanine transaminase (ALT) levels in the plasma were measured by rate method, and the levels of NO, ET-1, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in plasma were detected by enzyme-linked immunosorbent assay (ELISA). The plasma NO levels at the T time-point were significantly lower than those at the T and T time-points (P<0.05); at the T time-point, the concentrations of AST, ALT, ET-1, IL-6 and TNF-α in the plasma in Group A were significantly higher than those of Group B (P<0.05), while the levels of plasma NO in Group A were the opposite (P<0.05). The anesthesia of propofol combined with remifentanil could contribute to the balance of NO/ET-1 and the inhibition of inflammatory factors during the hepatectomy operation in patients with liver cirrhosis, and help to protect the liver function of patients, reducing the incidence of liver ischemia-reperfusion injury in patients.
研究了丙泊酚联合瑞芬太尼对肝硬化患者血浆中一氧化氮（NO）、内皮素（ET-1）及炎性细胞因子的影响。回顾性分析了2016年3月至2018年7月在湖南省人民医院行肝切除术的68例肝硬化患者。根据不同麻醉方法，将30例采用丙泊酚麻醉的患者纳入A组。另外38例采用丙泊酚联合瑞芬太尼麻醉的患者纳入B组，记录两组的手术时间、术中出血量及术后苏醒时间。在3个不同时间点T（麻醉前30分钟）、T（门静脉三联阻断后）、T（术后3天），采用速率法测定血浆中天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平，采用酶联免疫吸附测定（ELISA）法检测血浆中NO、ET-1、白细胞介素-6（IL-6）和肿瘤坏死因子α（TNF-α）水平。T时间点血浆NO水平显著低于T和T时间点（P<0.05）；在T时间点，A组血浆中AST、ALT、ET-1、IL-6和TNF-α浓度显著高于B组（P<0.05），而A组血浆NO水平则相反（P<0.05）。丙泊酚联合瑞芬太尼麻醉有助于肝硬化患者肝切除术中NO/ET-1平衡及炎性因子的抑制，有助于保护患者肝功能，降低患者肝缺血再灌注损伤的发生率。
