Effects of remifentanil on hemodynamics, liver function and ICAM-1 expression in liver cancer patients undergoing surgery.
Effects of remifentanil on hemodynamics, liver function and ICAM-1 expression in liver cancer patients undergoing surgery.
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DOI：
10.3892/ol.2017.6247
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发表时间：
2017-07
期刊：
影响因子：
2.9
通讯作者：
Luo H
中科院分区：
文献类型：
--
作者：
Jiang Q;Song X;Chen Z;Wang C;Luo H
本研究旨在探讨瑞芬太尼对肝癌手术患者血流动力学、肝功能和细胞间粘附分子-1（ICAM-1）表达的影响。选择2014年1月至2016年1月在湖北医药学院附属襄阳市第一人民医院行肝癌切除术的患者60例，男33例，女27例，平均年龄54.12±4.77岁。将患者随机分为对照组和实验组各30例。对照组和实验组分别用丙泊酚/异氟醚和瑞芬太尼/丙泊酚麻醉。除一般参数外，还分析了以下参数：在治疗前、麻醉诱导和插管期间、手术中牵引反射阻滞期间和手术结束拔管前获得平均收缩压和平均舒张压。记录两组患者从麻醉停止到自主呼吸的恢复时间、睁眼时间、拔管时间及意识水平。分别于术后第1、3、5、7天检测肝组织ICAM-1的表达，并检测肝组织中谷草转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆红素（TBIL）的表达。血流动力学参数观察组较对照组稳定（P<0.05）。另外，实验组的恢复时间短于对照组（P<0.05）。两组患者术后肝功能指标（AST、ALT、TBIL）均高于术前，实验组升高幅度明显低于对照组。实验组ICAM-1表达明显低于对照组（P<0.05）。结论：瑞芬太尼麻醉能更好地维持血流动力学的稳定，对肝脏缺血再灌注损伤具有保护作用，并能降低ICAM-1的表达。
The objective of the present study was to investigate the effects of remifentanil on hemodynamics, liver function, and expression of intercellular adhesion molecule-1 (ICAM-1) in patients with liver cancer undergoing surgery. A total of 60 patients who underwent liver cancer resection in The First People's Hospital of Xiangyang, Hubei University of Medicine from January 2014 to January 2016 were selected, including 33 males and 27 females, with an average age of 54.12±4.77 years. Patients were randomly divided into the control group and experimental group (n=30 each). The control group and experimental group were anesthetized with propofol/isoflurane and remifentanil/propofol, respectively. In addition to general parameters, the following parameters were analyzed: mean systolic blood pressure and mean diastolic blood pressure were obtained before treatment, during anesthesia induction and intubation, during blockade of traction reflexes in surgery, and before extubation at the end of surgery. The recovery time from anesthesia withdrawal to spontaneous breathing, time of eye opening, time of extubation, and level of consciousness were recorded. Liver expression of ICAM-1 was measured with SABC staining, and the expression of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) were recorded on the first, third, fifth, and seventh day after surgery. According to hemodynamic parameters, patients in the experimental group experienced a more stable condition than patients in the control group (P<0.05). In addition, the recovery time of the experimental group was shorter than that of the control group (P<0.05). Markers of liver function (AST, ALT and TBIL) of the two groups after surgery were higher than those before surgery, and the increases of the experimental group were significantly lower than those of the control group. ICAM-1 expression in the experimental group was significantly lower than in the control group (P<0.05). In conclusion, anesthesia with remifentanil better maintained the stability of hemodynamics, played a protective role against hepatic ischemia-reperfusion injury, and reduced ICAM-1 expression.