硫酸镁对二氧化碳气腹致肝脏 缺血-再灌注损伤的影响

Effect of magnesium sulphate on hepatic ischemia reperfusion injury by CO2 laparoscopy

摘要:

目的 观察硫酸镁对二氧化碳气腹致肝脏缺血-再灌注损伤的保护作用。方法 选择60例ASA I～II级在气管插管全身麻醉下行腹腔镜直肠肿瘤切除术的患者，随机分为硫酸镁组（M组，n =30）和对照组（C组，n =30）。硫酸镁组给予硫酸镁静脉输注，对照组给予等量生理盐水。观察两组术后肝酶、血浆内皮素（ET）、一氧化氮（N0）和白细胞介素-6（IL-6）的改变。结果 两组患者术后早期丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）均较术前升高（P <0.05）；硫酸镁预处理组与对照组比较，术后早期ALT、AST水平相对较低（P <0.05）。气腹结束后两组患者IL-6明显增加（P <0.05），N0浓度明显减少（P <0.05）；两组比较，硫酸镁组患者气腹后血浆IL-6、ET浓度相对较低（P <0.05），NO浓度相对更高（P <0.05）。结论 硫酸镁通过降低机体内ET-1、IL-6水平，提高NO水平，对气腹所致的肝脏缺血一再灌注损伤有一定保护作用，且可减轻机体的脂质过氧化状态。

Abstract:

【Objective】 To investigate the effect of magnesium sulphate on hepatic ischemia reperfusion injury (HIRI) by C02 laparoscopy. 【Methods】 Sixty ASA I~II patients undergoing laparoscopic surgery for rectal carcinoma were randomly divided into two groups: group M received magnesium sulphate and group C only accepted normal saline. Blood endothelin-1 (ET); nitric oxide (NO), interleukin-6 (IL-6) levels and general clinical data in peri-operation stage were compared between the two groups. 【Results】 Statistical analysis revealed significant increases in AST and ALT levels in both groups postoperatively. Compared with the control group, ALT, AST levels in group M were significantly lower (P <0.05). Significant elevations of IL-6 and decreases of N0 were detected in both groups after pneumoperitoneum (P <0.05), and for group M, the differences between NO concentrations were significantly higher compared with group C, whereas the IL-6, ET concentrations were significantly lower (P <0.05). 【Conclusion】Magnesium sulphate has a protective effect on hepatic ischemia reperfusion injury induced by decreasing ET-1, IL-6 content, increasing NO content, and it is concluded that this approach reduces lipid peroxidation stress.