【摘要】 目的观察乌司他丁门静脉局部应用及联合维拉帕米对人肝脏缺血再灌注损伤的保护作用。方法对切除肝叶或肝段的患者,肝门阻断前经胃网膜右静脉缓慢推注乌司他丁10wu或联合维拉帕米5mg。观察术后1天、3天实验组血清酶(ALT、AST)、脂质过氧化代谢产物MDA及病理变化。结果术后1天、3天实验组血清酶(ALT、AST)及脂质过氧化代谢产物MDA明显低于对照组,组间差异有非常显著意义(P<0.01);但联合用药组保护效应与单纯应用乌司他丁组无显著差异(P>0.05)。光学显微镜检查,实验组肝细胞病理损伤程度比对照组轻。结论肝门阻断前经门静脉应用乌司他丁对人肝脏缺血再灌注损伤具有明显的保护作用,但联合使用维拉帕米,未发现明显的协同作用。更多还原

【Abstract】 Objective To study the protective effect of Ulinastatin combined with/without Verapamilthrough portal vein on ischemia reperfusion injury of liver . Methods Thirty patients underwent liverresection were randomly divided into three groups , Ulinastatin group ( n =10): hepatectomy consequent10wu Ulinastatin injection through right gastroepiploic vein , combined group ( n = 10) : patients withhepatectomy were given by 5mg Verapamil and 10wu Ulinastatin through right gastroepiploic vein beforeblocking porta hepatica. Control group ( n = 10) :were injected by 25ml saline in the same way. Thevariations of postoperative liver function were measured. Hepatic histopathologic alterations werealso examined. Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase(AST) from the Ulinastatin group and conbined group increment less than those of the physiologicsaline group(353. 1 ±55. 2 vs 236. 5 ±42.0/226. 2±54.1; 310. 2 ±44.2 vs 186. 4 ±59.4/177. 6 ±33.9 etc. P < 0.01) . Meanwhile ,serum MDA were significantly lessened as well as the hepatic functionrestored earlier in Ulinastatin group and conbined group(9.55 ±3.38 vs 4.95±1.53/4.65±1.43, etc.P < 0.01). But there are no variations significant between the Ulinastatin group and conbined groupin there ALT/AST/MDA. Conclutions Injection of Ulinastatin through portal vein before blocking portahepatis , which shows a protective effect against hepatic ischemia - reperfusion injury for resectionof liver and has benefit for recovery of patients, but there is no effect significant combined by 5mgVerapamil simultaneous.更多还原