Effect of dexmedetomidine on liver function, cytokine levels, and oxidative stress in patients undergoing hepatolobectomy

Zhang Ning; Guo ZhenZhong; Cheng Yan

doi:10.3969/j.issn.1001-5256.2017.03.022

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Mar. 2017

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Effect of dexmedetomidine on liver function, cytokine levels, and oxidative stress in patients undergoing hepatolobectomy

DOI: 10.3969/j.issn.1001-5256.2017.03.022

General Hospital of Jizhong Energy Fengfeng Group Co., Ltd.

Published Date: 2017-03-20

Abstract

Abstract

Objective To investigate the effect of dexmedetomidine on liver function, plasma cytokine levels, and oxidative stress due to ischemia/reperfusion injury in patients undergoing hepatolobectomy.Methods A total of 106 patients who underwent hepatolobectomy in General Hospital of Jizhong Energy Fengfeng Group Co., Ltd.from January 2014 to January 2016 were enrolled and randomly divided into control group and observation group, with 53 patients in each group.The patients in the observation group were given 1 μg/kg/h dexmedetomidine within 10 minutes, followed by continuous intravenous infusion of 0.5 μg/kg/h dexmedetomidine, and those in the control group were given an equal volume of 0.9% sodium chloride.The two groups were compared in terms of liver function parameters, plasma cytokine levels, and oxidative stress due to ischemia/reperfusion injury after anesthesia (T1) , before abdominal closure (T2) , and at 1, 4, and 8hours after surgery (T3, T4, and T5, respectively) .The chi-square test was used for comparison of categorical data between groups;the t-test was used for comparison of indices between groups, the sphericity test was used for comparison of indices at different time points, and an analysis of variance was performed for repeated measurement data with P<0.05.Results The two groups had significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at T2, T3, T4, and T5 than at T1 (ALT:F=43.72 and 44.16, both P<0.001;AST:F=53.87 and 65.44, both P<0.001) , and the observation group had significantly lower levels than the control group at T2, T3, T4, and T5 (ALT:t=20.54, 22.01, 36.68, and 38.15, all P<0.001;AST:t=32.27, 41.08, 52.82, and 71.89, all P<0.001) .The two groups had significantly higher levels of tumor necrosis factor α (TNFα) and interleukin-8 (IL-8) at T3, T4, and T5 than at T1 (TNFα:F=54.37 and 24.75, both P<0.001;IL-8:F=47.24 and 27.39, both P<0.001) , and the observation group had significantly lower levels than the control group at T3, T4, and T5 (TNFα:t=59.39, 86.32, and 83.16, all P<0.001;IL-8:t=74.47, 72.29, and 76.67, all P<0.001) .The two groups had a significantly higher level of malondialdehyde at T3, T4, and T5 than at T1 (F=37.65 and 17.44, both P<0.001) , and the observation group had a significantly lower level than the control group at T3, T4, and T5 (t=17.35, 19.11, and 24.12, all P<0.001) .The two groups had a significantly lower level of superoxide dismutase at T3, T4, and T5 than at T1 (F=36.54 and 33.65, both P<0.001) , and the observation group had a significantly higher level than the control group at T3, T4, and T5 (t=68.64, 66.35, and 59.48, all P<0.001) .Conclusion Dexmedetomidine can effectively inhibit liver injury, reduce the levels of cytokines, and alleviate ischemia/reperfusion injury in patients undergoing hepatectomy.
- hepatectomy,
- reperfusion injury,
- cytokines,
- adrenergic alpha-agonists

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References

[1]ZHU ZJ, ZENG ZG.Research advances in auxiliary liver transplantation[J].J Clin Hepatol, 2015, 31 (12) :2020-2022. (in Chinese) 朱志军, 曾志贵.辅助性肝移植的研究进展[J].临床肝胆病杂志, 2015, 31 (12) :2020-2022.

[2]WANG QQ, ZHAO X, CHEN YC, et al.Research advances in mechanisms and intervention of hepatic ischemia-reperfusion injury[J].J Clin Hepatol, 2016, 32 (6) :1225-1229. (in Chinese) 王清卿, 赵鑫, 陈玉超, 等.肝脏缺血再灌注损伤机制及干预的研究进展[J].临床肝胆病杂志, 2016, 32 (6) :1225-1229.

[3]LI L, LU Y, DUAN FM, et al.Influence of dexmedetomidine on the liver function and cytokine levels in patients after hepatectomy[J].Shanxi Med J, 2016, 45 (14) :1619-1621. (in Chinese) 李玲, 路艳, 段凤梅, 等.右美托咪定对肝叶切除患者围术期肝功能及血浆细胞因子水平的影响[J].山西医药杂志, 2016, 45 (14) :1619-1621.

[4]LI L, FU H, LI RH, et al.Effect of flurbiprofen on ischemia reperfusion injury after hepatectomy[J].Chin J Gen Surg, 2016, 25 (1) :138-143. (in Chinese) 李玲, 傅华, 李汝泓, 等.氟比洛芬酯对肝叶切除术后缺血再灌注损伤患者的影响[J].中国普通外科杂志, 2016, 25 (1) :138-143.

[5]ZHENG SF, HUANG GH, LUO ZB, et al.Effect of dexmedetomidine on oxidative stress caused by hepatectomy ischemia-reperfusion injury[J].China Med and Pharm, 2015, 5 (24) :12-15. (in Chinese) 郑少峰, 黄贵和, 罗泽斌, 等.右美托咪定对肝切除缺血再灌注损伤氧化应激的影响[J].中国医药科学, 2015, 5 (24) :12-15.

[6]ZHANG Y, LI B, DU WZ, et al.The effect of dexmedetomidine on renal functions during the anesthesia of liver transplantation patients[J].J Clin Anesthesiol, 2016, 32 (2) :130-133. (in Chinese) 张宇, 李兵, 杜伟忠, 等.右美托咪定对肝移植手术中肾功能的影响[J].临床麻醉学杂志, 2016, 32 (2) :130-133.

[7]LI XY, XIE YY.Effect of dexmedetomidine on organ function and related mechanisms[J].Hebei Med J, 2016, 38 (4) :601-603. (in Chinese) 李晓燕, 解雅英.右美托咪定对器官功能的影响及机制[J].河北医药, 2016, 38 (4) :601-603.

[8]CHEN KY, ZHANG YN, DIAO YG, et al.Dexmedetomidine inhibits renal ischemia/reperfusion-induced inflammatory reaction[J].J Clin Rehabil Tissue Eng Res, 2013, 17 (53) :9189-9195. (in Chinese) 陈克研, 张毅男, 刁玉刚, 等.右美托咪定抑制肾缺血/再灌注炎性反应[J].中国组织工程研究, 2013, 17 (53) :9189-9195.

[9]ZHANG B, WANG T, MA LL.Comparison of sedative effect between dexmedetomidine and midazolam on severe patients[J].Clin J Med Offic, 2016, 44 (12) :1295-1296. (in Chinese) 张冰, 王通, 马琳琳.右美托咪定与咪达唑仑对重症患者镇静效果比较[J].临床军医杂志, 2016, 44 (12) :1295-1296.

[10]ZHONG W, LI R, LI Y, et al.Change characteristics of entropy in monitoring sedation depth of dexmedetomidine in patients before parathyroid autologous transplantation[J].Chin J Clin Pharmacol Ther, 2015, 20 (6) :665-668. (in Chinese) 钟玮, 李锐, 李云, 等.甲状旁腺自体移植术患者右美托咪定镇静的熵指数变化[J].中国临床药理学与治疗学, 2015, 20 (6) :665-668.

[11]LIU HM, YANG L.Influence of administration of dexmedetomidine before uterectomy in stress and immunologic function in patients[J].J Jilin Univ:Med Edit, 2015, 41 (6) :1245-1248. (in Chinese) 刘红梅, 杨莉.子宫切除术前给予右美托咪定对患者应激和免疫功能的影响[J].吉林大学学报:医学版, 2015, 41 (6) :1245-1248.

[12]LIU Y.Advances in the application of dexmedetomidine in anesthesia[J].Clin J Med Offic, 2015, 43 (6) :656-657. (in Chinese) 刘营.右美托咪定在麻醉中的应用进展[J].临床军医杂志, 2015, 43 (6) :656-657.

[13]CHEN YH, SUN YJ, ZHANG YN, et al.Effects of dexmedetomidine on levels of kindey injury molecule-1 and inflammatory cytokines in patients with septic shock[J].Clin J Med Offic, 2015, 43 (11) :817-820. (in Chinese) 陈艳红, 孙莹杰, 张毅男, 等.右美托咪定对感染性休克患者肾损伤分子-1和炎症因子的影响[J].临床军医杂志, 2015, 43 (11) :817-820.

[14]XING ZQ, BI JW, LIU ZL.Effect of dexmedetomidine on liver ischemia-reperfusion injury in patients undergoing partial hepatetomy[J].Hainan Med J, 2015, 26 (1) :121-122. (in Chinese) 幸志强, 毕继伟, 刘占立.右美托咪定对肝部分切除术患者肝缺血再灌注损伤的影响[J].海南医学, 2015, 26 (1) :121-122.

[15]BOSTANKOLU E, AYOGLU H, YURTLU S, et al.Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia[J].Kaohsiung J Med Sci, 2013, 29 (2) :75-81.

[16]YAGMURDUR H, OZCAN N, DOKUMACI F, et al.Dexmedetomidine reduces the ischemia-reperfusion injury markers during upper extremity surgery with tourniquet[J].J Hand Surg Am, 2008, 33 (6) :941-947.

[17]SAHIN T, BEGECZ, TOPRAK HI, et al.The effects of dexmedetomidine on liver ischemia-reperfusion injury in rats[J].J Surg Res, 2013, 183 (1) :385-390.

[18]CHEN YJ, GONG CL, TAN F, et al.Pretreatment with dexmedetomidine ameliorates renal inflammation and oxidative stress in rats with lipopolysaccharide-induced sepsis and acute kidney injury[J].J South Med Univ, 2015, 35 (10) :1472-1475, 1491. (in Chinese) 陈裕洁, 龚楚链, 谭芳, 等.右美托咪啶预处理对脓毒症肾损伤大鼠炎性因子和氧化应激的影响[J].南方医科大学学报, 2015, 35 (10) :1472-1475, 1491.

[19]DENG RX, ZHANG S, ZHANG JZ, et al.Dexmedetomidine in protection of inflammation and lung injury during general anesthesia[J].Chin J Nosocomiol, 2013, 23 (10) :2343-2345. (in Chinese) 邓若熹, 张晟, 张锦枝, 等.右美托咪定在全麻手术中对炎症及肺损伤保护作用的探讨[J].中华医院感染学杂志, 2013, 23 (10) :2343-2345.

[20]LI TZ.Application of dexmedetomidine in anesthesia[J].Beijing Med J, 2013, 32 (8) :587-590. (in Chinese) 李天佐.右美托咪啶在麻醉中的应用[J].北京医学, 2013, 32 (8) :587-590.

[21]XUE GJ, HAO JH.Advances in the application of dexmedetomidine in anesthesia for cardiovascular surgery[J].J Xinxiang Med Coll, 2016, 33 (1) :73-77. (in Chinese) 薛国剑, 郝建华.右美托咪定在心血管手术麻醉中的应用进展[J].新乡医学院学报, 2016, 33 (1) :73-77.

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Effect of dexmedetomidine on liver function, cytokine levels, and oxidative stress in patients undergoing hepatolobectomy

DOI: 10.3969/j.issn.1001-5256.2017.03.022