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七氟醚麻醉与丙泊酚麻醉对活体肾移植供者术后早期肾功能影响的比较:一项随机对照试验

Comparison of Effect Sevoflurane-Based Anesthesia and Propofol-Based Anesthesia on the Early Postoperative Renal Function of Living Kidney Transplant Donors: A Randomized Controlled Trial.

作者信息

Cai Jianyue, Kang Fang, Han Mingming, Huang Xiang, Yan Wenlong, Wan Fuzhen, Li Juan

机构信息

Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China.

Department of Gastrointestinal Surgery, The second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

出版信息

Drug Des Devel Ther. 2025 Jan 23;19:491-503. doi: 10.2147/DDDT.S486393. eCollection 2025.

DOI:10.2147/DDDT.S486393
PMID:39872635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11771174/
Abstract

PURPOSE

Living kidney transplantation is a common treatment for end-stage renal disease. The impact of anaesthetics on postoperative biomarkers of renal injury in living kidney transplant donors is not well understood.

PATIENTS AND METHODS

70 transplant donors who underwent kidney extraction were randomly assigned to following two groups: sevoflurane (S group) and propofol (P group). Urine and blood were collected before induction and 1, 2, 6 days after operation. Kidney injury marker-1 (KIM-1), interleukin-18 (IL-18) and tissue inhibitor of metalloproteinase-2 (TIMP-2) were measured by enzyme-linked immunosorbent assay. Record the cystatin C, glomerular filtration rate, urine output during perioperative period.

RESULTS

There were both increases in biomarkers of kidney injury before and 1, 2 and 6 days after the anaesthetic surgery in donors, However, no statistical differences in KIM-1 (P (0.42 pg/mL (95% CI 0.21 to 0.63 pg/mL)) vs S (0.26 pg/mL (95% CI 0.02 to 0.49 pg/mL)), -0.16 pg/mL (95% CI -0.48 to 0.16 pg/mL)), IL-18 (P (178.54 pg/mL (95% CI 110.15 to 24693 pg/mL)) vs S (175.86 pg/mL (95% CI 100.35 to 251.38 pg/mL)), -2.68 pg/mL (95% CI -105.61 to 100.25 pg/mL)), and TIMP-2 (P (12.88 ng/mL (95% CI 8.69 to 17.07 ng/mL)) vs S (14.85 ng/mL (95% CI 10.23 to 19.46 ng/mL)), 1.97 ng/mL (95% CI -4.30 to 8.23 ng/mL)) concentration changes between the two types of anaesthesia.

CONCLUSION

There was no difference between sevoflurane and propofol anaesthesia on postoperative changes in biomarkers of renal injury in living kidney transplant donors.

摘要

目的

活体肾移植是终末期肾病的常见治疗方法。麻醉对活体肾移植供体术后肾损伤生物标志物的影响尚不清楚。

患者与方法

70例接受肾脏摘除术的移植供体被随机分为以下两组:七氟醚组(S组)和丙泊酚组(P组)。在诱导前以及术后1天、2天和6天收集尿液和血液。采用酶联免疫吸附测定法检测肾损伤标志物-1(KIM-1)、白细胞介素-18(IL-18)和金属蛋白酶组织抑制剂-2(TIMP-2)。记录围手术期的胱抑素C、肾小球滤过率、尿量。

结果

供体在麻醉手术前以及术后1天、2天和6天肾损伤生物标志物均有升高,然而,两种麻醉方式之间KIM-1(P组(0.42 pg/mL(95%CI 0.21至0.63 pg/mL))与S组(0.26 pg/mL(95%CI 0.02至0.49 pg/mL)),-0.16 pg/mL(95%CI -0.48至0.16 pg/mL))、IL-18(P组(178.54 pg/mL(95%CI 110.15至246.93 pg/mL))与S组(175.86 pg/mL(95%CI 100.35至251.38 pg/mL)),-2.68 pg/mL(95%CI -105.61至100.25 pg/mL))和TIMP-2(P组(12.88 ng/mL(95%CI 8.69至17.07 ng/mL))与S组(14.85 ng/mL(95%CI 10.23至19.46 ng/mL)),1.97 ng/mL(95%CI -4.30至8.23 ng/mL))浓度变化无统计学差异。

结论

七氟醚麻醉和丙泊酚麻醉对活体肾移植供体术后肾损伤生物标志物的变化无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/6be4f2735d7d/DDDT-19-491-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/e4299eef6203/DDDT-19-491-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/1b2554414f19/DDDT-19-491-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/d5151f5c45b9/DDDT-19-491-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/6be4f2735d7d/DDDT-19-491-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/e4299eef6203/DDDT-19-491-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/1b2554414f19/DDDT-19-491-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/d5151f5c45b9/DDDT-19-491-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7eb/11771174/6be4f2735d7d/DDDT-19-491-g0004.jpg

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