【摘要】 目的探讨前列腺素E₁（PGE₁）对肝切除术后肝功能的保护作用及机制。方法选取118例接受肝大部切除术患者其中A组36例（术后常规治疗）,B组40例（术后常规治疗+PGE₁20μg/d,静脉注射,连续14d）,C组42例（术中门静脉阻断再开放行Lipo-PGE₁20μg门静脉灌注+B组方案）。分别检测3组患者术前与术后1、3、5、9、14、28d外周血ALT及TNF-α、IL-6、IL-1IFN-γ水平,以及术前与术后1、7、28d门静脉血流量的变化。结果3组患者术前各指标差异均无统计学意义（均P>0.05）。术后组患者ALT、TNF-α、IL-6、IL-10水平均明显升高,然后逐渐恢复,但B、C组升高幅度明显低于A组（均P<0.01）,且恢复时间快于组;A组IFN-γ水平在手术前后无明显改变,但B、C组在术后28d,IFN-γ水平明显持续升高（均P<0.01）。A组门静脉血流量手术后无明显改变,而B、C组术后门静脉血流量在观察时段内明显且逐渐增高（均P<0.05）。以上所有PGE₁干预引起的变化,C组均较B明显。结论 PGE₁有利于肝切除术后早期功能的恢复,其作用机制可能与调节细胞因子水平及增加门静脉血流有关。更多还原

【Abstract】 Objective To investigate the protective effect of prostaglandin E,(PGE,) on liver function in patients after hepatectomy.Methods One hundred and eighteen patients scheduled to undergo major liver resection were randomly designated to group A(receiving conventional postoperative treatment n=36),group B(receiving conventional treatment plus intravenous injection of 20μg/d Lipo-PGE,for 14d,n=40) and group C(undergoing portal vein infusion of 20 μg Lipo-PGE,immediately after portal vein clamping was finished during surgery plus the same regimen as group B,n=42).The levels of alanine transaminase(ALT) and cytokines TNF-α,IL-6,IL-10 and IFN-γ in peripheral blood were measured before and 1,3,5,9,14 and 28 d after surgery,and the portal venous flow volume was also determined before and 1,7 and 24 d after surgery.Results All parameters among the three groups had no significant differences before surgery(all P >0.05).The levels of TNF- α,IL-6 and IL-10 in all groups were markedly increased after surgery and then returned to baseline gradually,while these cytokines in groups B and C were increased significantly less and decreased shorter than those in group A(all P<0.05).The pre- and postoperative IFN-γlevels in group A showed no significant changes,but those in groups B and C were significantly increased and continued to rise until 28 d after surgery(all P<0.05).No difference was observed in portal venous flow volume before and after surgery in group A,while a continuous increase was found after surgery in groups B and C(all P<0.05).All the changes caused by PGE,intervention were more evident in group C than those in group B.Conclusion PGE,is beneficial for early recovery of liver function after hepatectomy,which may be related to regulating cytokines levels and increasing the portal venous inflow.更多还原