肿瘤坏死因子在肝缺血/再灌注损伤中的作用及异丙酚的干预

目的 探讨肿瘤坏死因子(TNF)在肝缺血/再灌注损伤(HIRI)中的作用及异丙酚对其的影响。方法 选择HIRI实验兔及肝癌手术患者,观察血浆TNF含量、谷丙转氨酶(ALT)活性、肝形态学的变化及异丙酚对上述指标的影响。结果 HIRI期间,TNF和ALT明显升高(P均<0.01),两者呈显著正相关(实验兔r=0.912,P<0.01;患者r=0.535,P<0.01),肝形态学发生异常变化;使用异丙酚后,上述指标的异常变化显著减轻,其差异有显著性意义(P<0.05和P<0.01)。结论TNF是HIRI的重要发病因素,异丙酚可通过降低TNF减轻HIRI。

Role of tumor necrosis factor in reperfusion injury following hepatic ischemia and effect of propofol

Objective To explore the role of tumor necrosis factor(TNF) in rabbit and humans during hepatic ischemia-reperfusioninjury (HIRI)and the effect of propofol on it. Methods Changes of several prameters and the effect of propofol on it were observed duringHIRI in 20 rabbits and 18 patients who were scheduled for elective hepatic surgery, parameters of which included TNF, alanine aminotransferase(ALT) and changes of hepatocytes morphology. Results TNF content and ALT activities significantly increased(P<0. 05and P<0. 01), andthe abnormal changes of hepatocytes morphology were obvious during HIRI. There was positive correlation between the changes of TNF and ALT(rabbits, r=0.912, P<0.01 and patients, r=0. 535, P<0. 01)during HIRI with treatment of propofol, the abovementioned abnormalchanges of all the parameters and hepatocytes morphology were all alleviated remarkably(P<0.05 and P<0.01). Conclusion TNF mightbe one of the primary causes for HIRI, and propofol could attenuate HIRI by eliminating TNF.