Effects Of Sevoflurane On The Endothelial Glycocalyx During Hepatic Ischemia-reperfysion Period

Object To further investigate the extent and mechanism of hepatocytes andendothelial glycocalyx injury on ischemia-reperfusion, and to explore the effectsof sevoflurane on it.Material and methods Thirty guinea pigs were divided into five groups: groupA was ketamine time-control group, Group B was ketamine ischemia-reperfusion injury group, Group C was sevoflurane time-control group, Group Dwas sevoflurane ischemia-reperfusion injury group, Group E was ischemia-reperfusion group with sevoflurane and hydrocortisone. After anesthesia withketamine or sevoflurane, warm ischemia was induced for45min inischemia-reperfusion groups, followed by20min reperfusion. To the time-control group, only reperfuion injury was performed. After isolating the liverfrom the body of the rats, the infusion was performed immediately. Samples ofeffluent were collected between minutes of0~2.5,5~7.5,15~17.5,35~37.5afterthe onset of reperfusion and then saved in the refrigerator of-20℃. Parametersincluding the concentration of AST, ALT, shedding of components of glycocalyx(heparan sulfate, syndecan-1, and hyaluronic acid) were measured. Microscopywas used to see the immunohistochemical characterization of endothelialglycocalyx, and the electron microscopy was used to see the changes of theendothelial glycocalyx during ischemia-reperfusion period. Results1. A great deal of hepatocytes were insulted due to the ischemia-reperfusion injury; Compared with other groups, sevofluraneespeciallysevoflurane combining with hydrocortisone can decrease the concentration ofAST, ALT.2.The concentration of endothelial glycocalyx (haparan sulfate,syndecan-1, and hyaluronan) was increased obviously during the ischemia-reperfusion period; Electron microscopy with lanthanum staining to visibleendothelial glycocalyx showed severe shedding of glycocalyx on endovascularsurface in ischemia-reperfusion injury group. Sevofluraneespecially sevofluranecombining with hydrocortisone obviously decreased the shedding of endothelialglycocalyx.Conclusions:1. Ischemia-reperfusion injury can cause the shedding of endothelialglycocalyx.2. Sevoflurane pretreatment can decrease the destruction of the hepatocytes,if combined with hydrocortisone, the potection effects of sevoflurane were moreobviously.3. Sevoflurane pretreatment can decrease the shedding of endothelialglycocalyx; if combined with hydrocortisone, the potection effects ofsevoflurane were more obviously.