Liver Function Protective Effect Of S-adenosylmethionine On Primary Hepatocellular Carcinoma After Partial Hepatectomy

【Background and Objective】There are still lots of patients who suffered from primary hepatic carcinoma inourcountry. Surgical procedures are still the major treatment, associate with combinedmodality therapy(Such as general therapy, radiotherapy and chemotherapy). It is widelyaccepted that liver blood is supplied by portal vein and hepatic artery. Therefore, the livershared more blood than other organs owing to its unique anatomiy. In modern hepaticsurgeon, clamping of liver hilum(Pringle’s maneuver), has been utilized in order to reduceblood loss before hepatectomy. Hepatic pedicle clamping would induce the severe liver I/Rinjury, even though it is a convenient and available practice for controlling bleeding fromhepatic would surface. How to attenuate liver I/R injury the same as prevent blood loss isan urgent-resovling problem.There’re so many kinds of medicine using in ptotecting liver function, and they areoften given postoperative, hardly using preoperative. Using diverses of medicineassociation may be more helpful to the recovery of liver injury, its effect is limited, evenmore it will increase the burden of hepatic metabolic. Therefore, developing a new drugwhich have low toxic, side-effect and more helpful to fix the liver injury would be veryimportant.S-Adenosylmethionine, molecular weight:398, participates in the synthesis of GSH inhuman body, alleviates the injury induced by oxidative stress; promotes the synthesis ofadenosine methionine-dependent nature of membrane phospholipid, fixes the fluidity ofthe cell membrane, reduces the increase of postoperative acute total bilirubin; overcomesthe barriers of transsulfuration radical reaction, promotes the synthesis of thiol during theendogenous detoxification process; inhibits the activation of hepatic stellate cells,eliminates the progress of liver fibrosis; S-Adenosylmethionine is also the main methyldonor of human body, which can also increase DNA methylation, inhibit the developmentof malignant tumor. Based on the effect of S-Adenosylmethionine, we propose the following conjecture:giving S-Adenosylmethionine to the patients preoperative, can effectively weaken theliver injury, promote the early recovery of liver function after operation. This researchadopts the prospective clinical randomized controlled trial method(RCT), take case study,combine with the partial liver specimens for laboratory testing, in order to prove theabove hypothesis.【Methods】1. Prospective clinical randomized controlled trial method (RCT)2. Observing the indexes of liver function on preoperative, postoperative1,3,5days.3. Testing the oxidative stress markers.(Cu-ZnSOD, MDA, GSH-Px)【Results】TBil,ALT,AST rose to a certain entent, and inclined to recover two weeks afterhepatectomy. ALT on postoperative day1,3,5, in the therapy group is better than thecontrol group(P<0.05); AST on postoperative day1,3was better than the controlgroup(P<0.05); LDH on postoperative day1,3is better than the control group(P<0.05);AST isozymes on postoperative day1is better than the control group(P<0.05);ALP onpostoperative day1,3is better than the control group(P<0.05).The oxidative stress markers: The concentration of Cu-ZnSOD, MDA, GSH-Px in thetherapy group are better than the control group(P<0.05)【Conclusions】The liver-protecting effect of S-Adenosylmethionine is sure. S-Adenosylmethionine is agenuine therapeutic action in the development of preoperative liver function damagerestoration．It could have a certain degree of clinical use value.