The Influence On Liver And Kidney Of 6% Hydroxyethyl Starchs Aceticum Electrolyte Injection During Cardiac Value Replacement Treatment

Objective:To explore the effects of 6% 130/0.4 Hydroxyethyl starch electrolyte injection used as volume treatment on hepatorenal function during Rheumatic valvular replacement operation compairing with 6% 130/0.4 Hydroxyethyl starch sodium chloride injection.Methods:Selecting 80 patients who would undergo rheumatic valvular replacement operation conformd to the inclusion criteria.Using 6% 130/0.4 Hydroxyethyl starch sodium chloride injection as the positive control.Patients were randomly divided into two groups:HES sodium chloride injection group,HES electrolyte injection group.Patients were received conventional anesthesia induction after entering operation room.Corresponding experimental liquid were used as intravenous infusion liquid and cardiopulmonary bypass priming liquid in two groups.HES sodium chloride injection group infused HES sodium chloride injection and HES electrolyte injection group infused HES electrolyte injection.Collecting venous blood of each group to detect hepatorenal function indexes after anesthesia induction immediately?after operation immediately?6h and 24 h after operation.Hepatic functions indices including alanine aminotransferase(ALT),aspartate aminotransferase(AST),AST/ALT?total bilirubin(TBil)?direct bilirubin(Dbil)?glutamine transferase(GGT)?prealbumin(PA);Renal functions indices including:creatinine(Cr)?urea?Uric Acid(UA)?carbon dioxide(CO2).Results:In this experiment,we observed the integrity of hepatocyte by detecting ALT,AST and AST/ALT.We found a rise on AST and AST/ALT at the time of after operation immediately,6h and 24 h after operation when compared with anesthesia induction immediately between HES sodium chloride injection group and HES electrolyte injection group.What is more,we also found a rise on AST/ALT 6h end of operation when compared with end operation immediately between the two groups.AST in HES sodium chloride injection group at 6h and 24 h after operation were higher than that at the time of end operation immediately,while ALT at anesthesia induction immediately,after operation immediately and 6h after operation were lower than that at 24 h after operation.Comapared with after operation immediately,there were differences between ALT at 6h,24 h after operation in HES electrolyte injection group(P<0.05).We found a reduction on ALT,AST in HES electrolyte injection group when compared with HES sodium chloride injection group(P<0.05).Compared with anesthesia induction and after operation immediately,TBil in two groups were rising at 6h,24 h after operation(P<0.05).The variation trend on Dbil in HES electrolyte injection group was the same as TBil and in HES sodium chloride injection group was the same as AST/ALT,there was no difference between within groups and among groups on GGT(P>0.05).The variation trend on PA was the same as AST/ALT in two groups.Cr,Urea and Ua at 24 h after operation were higher than that at the time of anesthesia induction and after operation immediately and Cr at24 h after operation were still higher than 6h after operation in HES sodium chloride injection group.The variation trend on Urea in HES electrolyte injection group was the same as in HES sodium chloride injection group,while Cr in HES electrolyte injection group was higher at 6h after operation than anesthesia induction and after operation immediately,Ua at anesthesia induction immediately was lower than that after operation immediately,6h and 24 h after operation(P<0.05).Compared with HES sodium chloride injection group,we found a reduction on Cr and Urea in HES electrolyte injection group(P<0.05).HCO3-in two groups at after operation immediately and 6h after operation were lower than that at anesthesia induction im-mediately,further more,HCO3-at 24 h after operation were higher than that at after operation immediately and 6h after operation.We also found a rise in HCO3-at 24 h after operation than anesthesia induction immediately in HES electrolyte injection group(P<0.05).Compared with HES sodium chloride injection group,a rise was found on HCO3-at 24 h after operation(P<0.05).Conclusion:Under the experimental condition,the two colloidal solutions had no significant influence on hepatorenal function,and HES electrolyte injection better than HES sodium chloride injection.