Tiainen P, Rosenberg P H
Department of Anaesthesiology, Surgical Hospital, Helsinki University Central Hospital, Finland.
Br J Anaesth. 1996 Dec;77(6):744-7. doi: 10.1093/bja/77.6.744.
Subclinical disturbance in hepatocellular integrity, indicated by glutathione transferase Alpha (GSTA), has been associated with halothane, sevoflurane and propofol, but not with isoflurane anaesthesia. We anaesthetized 82 patients with isoflurane or halothane at 1 MAC for superficial surgery. GSTA concentration were measured with a sensitive time-resolved immunofluorometric assay in serum samples. GSTA concentrations increased from a baseline value of geometric mean 1.8 micrograms litre-1 (95% confidence intervals 1.4-2.2 micrograms litre-1) to a peak of 4.3 (3.3-5.7) micrograms litre-1 in the isoflurane group and from 2.1 (1.6-2.9) micrograms litre-1 to 6.2 (4.1-9.5) micrograms litre-1 in the halothane group. The change in GSTA was significant within groups but the difference between groups was not significant. Two patients exhibited an unexpectedly large increase in GSTA (peaks 370 and 620 micrograms litre-1) and a mild increase in alanine aminotransferase after halothane anaesthesia. We conclude that hepatocellular integrity was mildly disturbed after isoflurane and halothane anaesthesia but there was no difference between anaesthetics. Halothane anaesthesia may be associated with more advanced hepatocellular disturbance in some cases.
谷胱甘肽转移酶α（GSTA）所表明的肝细胞完整性的亚临床紊乱，与氟烷、七氟烷和丙泊酚有关，但与异氟烷麻醉无关。我们对82例接受浅表手术的患者使用异氟烷或氟烷在1个最低肺泡有效浓度（MAC）下进行麻醉。采用灵敏的时间分辨免疫荧光测定法测量血清样本中的GSTA浓度。在异氟烷组中，GSTA浓度从几何均值1.8微克/升的基线值（95%置信区间为1.4 - 2.2微克/升）升至峰值4.3（3.3 - 5.7）微克/升，在氟烷组中从2.1（1.6 - 2.9）微克/升升至6.2（4.1 - 9.5）微克/升。GSTA的变化在组内具有显著性，但组间差异不显著。两名患者在氟烷麻醉后出现GSTA意外大幅升高（峰值分别为370和620微克/升）以及丙氨酸转氨酶轻度升高。我们得出结论，异氟烷和氟烷麻醉后肝细胞完整性受到轻度干扰，但不同麻醉剂之间无差异。在某些情况下，氟烷麻醉可能与更严重的肝细胞紊乱有关。
