The Effects Of Shenfu Injection Pretreatment Combined With Controlled Low Central Venous Pressure On Hepatic Ischemia-reperfusion Injury

Objective To investigate the protective effects and mechanism of shenfu injection pretreatment combined with controlled low central venous pressure(LCVP)on hepatic ischemia-reperfusion injury(HIRI) during liver resection.Methods Eighty ASAⅠor ASA Ⅱ patients scheduled for liver resection were randomly divided into four groups:Shenfu pretreatment and controlled low central venous pressure group(group SL),shenfu pretreatment group(group S),controlled low central venous pressure group(group L),control group(group C),twenty patients for each group.The venous blood samples were drawn from the internal carotid vein at different time points : pre-occlusion ten minutes(T1),post-occlusion five minutes(T2),six hours(T3),twenty-four hours(T4),then detected the levels of serum superoxide dismutase(SOD),Interleukin-10(IL-10),Alanine aminotransferase(ALT)and Aspertate aminotransferase(AST).Results In four groups, the levels of serum SOD were highest at T1 among the four time points,then declined gradually until T4,and the levels of serum SOD were significantly lower at T1 than at the other time points(P<0.05). At T2,T3 andT4,the levels of SOD in group S and group SL were significantly higher than those in group C(P<0.05).The levels of serum ALT、AST、IL-10 were the lowest at T1 in four groups,then increased rapidly from T2 to T4,and they were significantly higher at T1 than at the other time points(P<0.01). At T2,T3 andT4,the levels of serum ALT、AST in group S and group L were both significantly lower than those in group C(P<0.05),while higher than those in group SL(P<0.01).At T2,T3 andT4,the levels of serum IL-10 in group S and group L were both significantly higher than those in group C(P<0.01),while lower than those in group SL(P<0.01).Conclusion:Shenfu injection pretreatment combined with controlled low central venous pressure in liver resection may have an effective protection on hepatic ischemia-reperfusion injury.The protective mechanism is probably that they trigger the endogenous resistance to injury mechanism and block up multiple factors which lead to hepatic ischemia-reperfusion injury.