【摘要】 目的 观察滴注还原型谷胱甘肽对原位肝移植患者围术期血浆氧自由基代谢水平的影响并探讨其作用机制。方法 将20例行原位肝移植术患者，随机分为谷胱甘肽组及对照组两组，谷胱甘肽组：切皮后滴注还原型谷胱甘肽(阿托莫兰)1.8g(加入100ml生理盐水)，每4h重复滴注；对照组：以等量生理盐水代替，测定比较两组患者切皮前、无肝前期120min、无肝期30min、新肝期5min、60min及术毕和术毕12h血浆中丙二醛(MDA)，超氧化物歧化酶(SOD)，一氧化氮(NO)及总抗氧化能力(TAC)水平。结果 还原型谷胱甘肽组较对照组患者新肝期后血浆MDA含量及NO水平明显减低(P<0.05), SOD活性及TAC水平升高(P<0.05)。结论 还原型谷胱甘肽可有效清除肝移植患者体内氧自由基, 对于减轻围术期的炎性反应和新肝期的再灌注损伤有较重要的临床意义。

     【关键词】 肝移植；还原型谷胱甘肽；氧自由基；缺血再灌注损伤

    Effects of glutathione on oxygen free radicals of patients plasma during orthotopic liver transplantation

    JIANG Xiao-qing, WANG Yu, CHEN Zhong-qing, et al.Department of Anesthesia, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515,China

    【Abstract】 Objective To study the effects of glutathione (GSH) on oxygen free radicals of patients plasma during orthotopic liver transplantation(OLT).Methods Twenty patients with end-stage liver diseases, undergoing OLT were randomly divided into two groups: glutathione group(groupA) received intravenous infusion of 1.8g atomolan in 100ml normal saline after skin incision and every 4 hours thereafter; control group (group C) received same amount of normal saline instead of. Atomolan, blood samples were taken before skin incision, 120 min after skin incision, 30 min after liver was removed(anhepatic phase), 5 min and 60 min after reperfusion of the graft, and at the end of operation and 12 hours later for measure of plasma MDA, SOD, NO and TAC concentration. Results In group A, plasma MDA and NO concentrations became significantly lower ......