【摘要】 目的探讨银杏叶提取物经门静脉预处理对肝脏手术中氧化应激的影响。方法选择需肝门阻断行肝部分切除手术的患者60例,男38例,女22例,年龄28⁶7岁,ASAⅠ或Ⅱ级,心功能I或II级,肝功能Child-Pugh A级。随机分为三组:门静脉注射组（P组）、颈内静脉注射组（J组）和对照组（C组）,每组20例。P组在游离出门静脉后经门静脉缓慢注射银杏叶提取物注射液5ml,J组游离出门静脉后经颈内静脉缓慢注射银杏叶提取物注射液5ml,C组游离出门静脉后经颈内静脉缓慢注射生理盐水5ml。分别于肝门阻断前10 min（T₀）、肝门开放后1h（T₁）、6h（T₂）、24h（T₃）经颈内静脉采血检测血清ALT、AST、TNF-α、丙二醛（MDA）浓度和超氧化物歧化酶（SOD）活性。结果与T₀时比较,T₁^T₃时三组血清ALT、AST、TNF-α和MDA浓度明显升高,SOD活性明显降低（P<0.05）。与C组比较,T₁^T₃时J组、P组血清ALT、AST、TNF-α和MDA浓度明显下降,SOD活性明显升高（P<0.05）。与J组比较,T₁^T₃时P组血清ALT、AST、TNF-α和MDA浓度明显下降,SOD活性明显升高（P<0.05）。结论银杏叶提取物经门静脉预处理通过升高SOD活性,抑制库普弗细胞（Kupffer cells,KC）活化,减少TNF-α释放,增强体内抗氧化应激能力,有助于减轻肝脏缺血-再灌注损伤。更多还原

【Abstract】 Objective To investigate the effect of pre-treatment of ginkgo biloba extract from portal vein on oxidative stress in liver surgery.Methods Sixty cases of hepatic portal occlusion for hepatectomy surgery in patients（38males,22 females,ASA gradeⅠ orⅡ,cardiac function Ⅰ orⅡ,Child-Pugh class A）,were randomly divided into three groups（n=20 each）:portal vein injection group（group P）,jugular vein injection group（group J）and control group（group C）.Patients in group P were injected with ginkgo biloba extract injection 5 ml slowly from portal vein after freeing the portal vein,patients in group J were injected with ginkgo biloba extract injection 5ml slowly from the jugular vein after freeing the portal vein,while patients in group C were injected with normal saline 5ml slowly from the jugular vein after freeing the portal vein.Venous blood samples were drawn from jugular vein at the following time points:pre-occlusion ten minutes（T₀）,1h（T₁）,6h（T₂）,24h（T₃）after reperfusion respectively,and then detected the levels of ALT,AST,tumor necrosis factor（TNF-α）, manlondialdehyde（MDA）and the activity of superoxide dismutase（SOD）.Results Compared with T₀,the serum levels of ALT,AST,TNF-αand MDA at T₁-T₃ were significantly increased,the activity of SOD was significantly decreased in all groups（P<0.05）.Compared with group C,serum levels of ALT,AST,TNF-αand MDA at T₁-T₃ were significantly decreased,the activity of SOD was significantly increased in groups J and P（P<0.05）.Compared with group J,serum levels of ALT,AST,TNF-αand MDA at T₁-T₃ were significantly decreased,the activity of SOD was significantly increased in group P（P<0.05）.Conclusion The pre-treatment of ginkgo biloba extract from portal vein can increase the SOD activity,inhibit the activation of Kupffer cells,reduce the release of TNF-α,enhance the ability of anti-oxidative stress and produce significant protective effect on liver ischemia-reperfusion injury.更多还原