Effects Of Tanshinone-Ⅱ_A Sodium Injection Post-Conditioning Combined With Controlled Low Central Venous Pressure On The Hepatic Ischemia-Reperfusion Injury

Objective:To investigate the protective effects of tanshinone-Ⅱ_A sodium injection post-conditioning combined with controlled low central venous pressure on hepatic ischemia-reperfusionon injury during liver resection and its possible mechanism.Methods:Eighty patients scheduled for liver resection,46 males and 34 females,ASA physical statusⅠorⅡ,were randomly divided into four groups:tanshinone-Ⅱ_A sodium post-conditioning（group D）,tanshinone-Ⅱ_A sodium post-conditioning combined with controlled low central venous pressure（CVP 1-5 cm H₂O）group（group DL）,controlled low central venous pressure（CVP 1-5 cm H₂O）group（group L）and control group（group C）that take the static-compound anesthesia and maintained CVP 6-12 cm H₂O,20 in each group.The venous blood samples were draw from internal carotid vein at different time point:pre-occlusion ten minutes（T₀）,post-occlusion 2 h（T₁）,6 h（T₂）,12 h（T₃）,24 h after operation（T₄）,and then detected the levels of NF-κB,ICAM-1,ALT and AST.The MAP,HR and CVP were recorded.Results::Compared with group C and group D,CVP were significantly lower at T₀ and T₁in group L and group DL（P<0.01）.Compared with T₀,levels of NF-κB,ICAM-1,ALT and AST in four group at T₁-T₄ were significantly increased（P<0.01）.Compared with group C,levels of NF-κB,ICAM-1,ALT and AST in group DL,group L and group D at T₁-T₄ were significantly decreased（P<0.05）.Compared with group DL,level of NF-κB,ICAM-1,ALT and AST in group D and group L at T₁-T₄were significantly increased（P<0.01）.Conclusion:Tanshinone-Ⅱ_A sodium injection post-conditioning combined with controlled low central venous pressure in patients with partial hepatectomy,can reduce the degree of ischemia-reperfusion injury.