Nishiyama T, Yokoyama T, Hanaoka K
Department of Anesthesiology, University of Tokyo, Japan.
Can J Anaesth. 1998 Aug;45(8):753-6. doi: 10.1007/BF03012146.
Although both sevoflurane and isoflurane are thought to be less hepatotoxic than halothane or enflurane, recent case reports have described liver injury after sevoflurane or isoflurane anaesthesia. There are no studies comparing liver function after sevoflurane or isoflurane anaesthesia. The purpose of this study was to compare serum liver enzyme concentrations in patients receiving either sevoflurane or isoflurane anaesthesia prospectively.
Ninety patients scheduled for elective neurosurgery were studied. Serum concentrations of aspartame aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GTP), and lactate dehydrogenase (LDH) were measured before and, 1, 2, 3, 7, and 14 days after either sevoflurane (45 patients) or isoflurane (45 patients) anaesthesia.
AST, ALT and GTP increased peaking seven days after anaesthesia, especially in the isoflurane group. The numbers of patients with abnormal values in AST and ALT were not different in the isoflurane from that in the sevoflurane group. The increase in TBil peaked one day after anaesthesia in both groups.
Even in a small number of patients, isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane three to 14 days after anaesthesia.
虽然七氟烷和异氟烷被认为比氟烷或恩氟烷的肝毒性小，但最近的病例报告描述了七氟烷或异氟烷麻醉后出现肝损伤。尚无比较七氟烷或异氟烷麻醉后肝功能的研究。本研究的目的是前瞻性比较接受七氟烷或异氟烷麻醉患者的血清肝酶浓度。
对90例择期神经外科手术患者进行研究。在七氟烷（45例患者）或异氟烷（45例患者）麻醉前、麻醉后1、2、3、7和14天测量血清天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBil）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GTP）和乳酸脱氢酶（LDH）的浓度。
AST、ALT和GTP在麻醉后7天升高至峰值，尤其是在异氟烷组。异氟烷组AST和ALT值异常的患者数量与七氟烷组无差异。两组TBil在麻醉后1天达到峰值。
即使在少数患者中，异氟烷麻醉后3至14天比七氟烷更频繁地引起血清肝酶水平升高。
