Tiainen P, Lindgren L, Rosenberg P H
Department of Anaesthesiology, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1995 Aug;39(6):840-4. doi: 10.1111/j.1399-6576.1995.tb04181.x.
Propofol anaesthesia has not been associated with any hepatic consequences. We used glutathione transferase Alpha (GSTA), a very sensitive indicator of hepatocellular integrity, to evaluate the effect of propofol on the liver. Total intravenous anaesthesia was induced and maintained with propofol without any supplements in 30 female patients undergoing breast surgery. Ten healthy female volunteers given the lipid vehicle of propofol served as controls. Serum GSTA concentration was measured with a sensitive time-resolved immunofluorometric assay. Total intravenous propofol anaesthesia was stable and postoperative nausea negligible. A significant increase in GSTA from 3.1 micrograms.l-1 (mean baseline) to 10.0 micrograms.l-1 (mean peak) was noted after propofol infusion, indicating subclinical disturbance in hepatocellular integrity. No change in aminotransferases and no clinical signs of hepatotoxicity were observed. A small increase in GSTA from 2.4 micrograms.l-1 (mean baseline) to 4.1 micrograms.l-1 (mean peak) was observed during lipid infusion. We detected a subclinical disturbance in hepatocellular integrity after propofol anaesthesia for breast surgery. The mechanisms of hepatocellular impairment are not clear but the lipid vehicle of propofol alone does not explain it.
丙泊酚麻醉未发现与任何肝脏后果相关。我们使用谷胱甘肽转移酶α（GSTA），这是一种对肝细胞完整性非常敏感的指标，来评估丙泊酚对肝脏的影响。30例接受乳腺手术的女性患者采用丙泊酚诱导并维持全静脉麻醉，未使用任何辅助药物。10名接受丙泊酚脂质载体的健康女性志愿者作为对照。采用灵敏的时间分辨免疫荧光分析法测定血清GSTA浓度。全静脉丙泊酚麻醉平稳，术后恶心轻微。输注丙泊酚后，GSTA从3.1微克/升（平均基线值）显著增加至10.0微克/升（平均峰值），表明肝细胞完整性存在亚临床紊乱。未观察到转氨酶变化及肝毒性的临床体征。输注脂质期间，GSTA从2.4微克/升（平均基线值）小幅增加至4.1微克/升（平均峰值）。我们发现在乳腺手术丙泊酚麻醉后存在肝细胞完整性的亚临床紊乱。肝细胞损伤的机制尚不清楚，但单独的丙泊酚脂质载体无法解释这一现象。
