Effects of tanshinone-Ⅱa sodium injection post-conditioning combined with controlled low central venous pressure on the hepatic ischemia-reperfusion injury / 临床麻醉学杂志

ABSTRACT

Objective To investigate the protective effects of tanshinone-IIA sodium injection post-conditioning combined with controlled low central venous pressure on hepatic ischemia-reperfusion injury during liver resection.Methods Eighty patients scheduled for liver resection, 46 males and 34 females, aged 30-65 years, BMI 20-26 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into four groups tanshinone-IIA sodium post-conditioning (group D), tanshinone-IIAsodium post-conditioning combined with controlled low central venous pressure (CVP 1-5 cm H2O) group (group DL), controlled low central venous pressure (CVP 1-5 cm H2O) group (group L) and control group (group C) that took the static-compound anesthesia and maintained CVP 6-12 cm H2O, 20 cases in each group.The venous blood samples were drawn from internal carotid vein at different time point pre-occlusion ten minutes (T0), post-occlusion 2 h (T1), 6 h (T2), 12 h (T3), 24 h after operation (T4), and then detected the levels of NF-κB, intercellular cell adhesion molecule-1 (ICAM-1), ALT and AST.The MAP was detected, HR and CVP were recorded.Results Compared with group C and group D, CVP were significantly lower at T0and T1in group L and group DL (P＜0.01).Compared with T0, levels of NF-κB, ICAM-1, ALT and AST in four group at T1-T4were significantly increased (P＜0.01).Compared with group C, levels of NF-κB, ICAM-1, ALT and AST in group DL, group L and group D at T1-T4 were significantly decreased (P＜0.05).Compared with group DL, levels of NF-κB, ICAM-1, ALT and AST in group D and group L at T1-T4 were significantly increased (P＜0.01).Conclusion Tanshinone-IIA sodium injection post-conditioning, combined with controlled low central venous pressure in patients with partial hepatectomy, can reduce the degree of ischemia-reperfusion injury.