Effects Of Limb Remote Ischemic Preconditioning On Levels Of Serum TNF-? And HMGB1 In Liver Operation

Objective: To investigate the effects of limb remote ischemic preconditioning on levels of serum tumor necrosis factor-?(TNF-?)and high mobility group box 1protein B1(HMGB1)in liver operation.Methods: Sixty patients,ASA I or II,undergoing selective partial liver resection were randomly divided into two groups : limb remote ischemic preconditioning group(group R)received the right upper limb ischemic preconditioning,Contral group(group C)without pretreatment.The blood samples were collected from the central venous cather at the following time points: 10 minutes before liver ischemia(T0),1h(T1)?6h(T2)?24h(T3)?48h(T4)after reperfusion respectively;Then the aspertate aminotransferase(AST),alanine aminotransferase(ALT)and TNF-?,HMGB1 were measured.Meanwhile,we documented the patients' heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP)at each time point and the incidence of postoperative complication,average hospitalization days.Results: Compared with T0,the serum levels of AST,ALT and TNF-?,HMGB1 were significntly higher at T1 to T4 in both groups(P<0.05);Compared with group C,the serum levels of f AST,ALT and TNF-?,HMGB1 in group R were significntly lower(P<0.05).There were no differents in the patients' HR,MAP,CVP at each time point and the incidence of postoperative complications,average hospitalization days between the two groups(P>0.05).Conclusion: Limb remote ischemic preconditioning applied for partial liver resection can relieve the elevation of serum liver enzyme levels postoperatively,protecting liver function which might be related to the down-regulation of serum TNF-? and HMGB1 levels,and reduce the inflammatory reaction in liver ischemia-reperfusion.