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Received:December 05, 2022 Published Online:September 19, 2023
Received:December 05, 2022 Published Online:September 19, 2023
中文摘要: 目的 探讨肝切除患者术前应用精氨酸,诱导自噬表达,进一步减轻肝切除患者术后肝功能的损伤,为临床减轻肝切除术后患者肝功能损伤提供新思路。方法 选择2019年1月至2020年12月徐州市中心医院肝胆胰中心行肝切除的肝细胞肝癌患者共90例,其中30例为正常肝切除组,即对照组；60例患者术前应用精氨酸,即试验组（连续输液1周为试验组1,共30例；间隔1日输液,连续1周为试验组2,共30例）。术后监测患者肝功能水平；行western blot检测患者肝脏组织自噬蛋白及凋亡蛋白的变化；比较患者住院时间。结果 试验组的肝功能水平较对照组患者术后肝功能水平减低,且试验组2优于试验组1（P＜0.05）。试验组2患者的正常肝脏组织的自噬蛋白LC3-Ⅱ水平高于对照组和试验组1（P＜0.05）。试验组患者的正常肝脏组织凋亡蛋白水平低于对照组,试验组2优于试验组1（P＜0.05）。对照组和试验组患者肝脏HE染色均显示不同程度的坏死、脂肪变性等,但试验组2患者肝脏HE染色损伤评分低于试验组1和对照组（P＜0.05）。试验组1住院时间为（16.1±3.8） d，试验组1住院时间为（15.3±3.1） d，对照组住院时间为（18.0±2.8）d，三组间差异有统计学意义（F=5.428， P<0.01）。试验组1和试验组2的住院时间短于对照组（P＜0.05）。结论 术前应用精氨酸可以诱导机体自噬水平的表达,在一定程度上可以缓解肝切除患者术后肝功能的损伤,且术前间隔使用精氨酸效果对肝功能缓解的效果更加明显。
中文关键词: 精氨酸； 肝癌； 肝切除； 自噬 缺血再灌注损伤
Abstract:Objective To discuss the preoperative application of arginine for inducing autophagy to alleviate postoperative liver damage in patients undergoing liver resection. Methods Out of 90 hepatocellular carcinoma （HCC） patients treated with liver resection in Xuzhou Central Hospital from January 2019 to December 2020, there were 30 patients with normal liver resection （control group） and 60 patients with preoperative application of arginine （experiment group）. In experiment group, continuous intravenous arginine infusion was given for 1 week in 30 cases （experiment group 1）, and intravenous infusion every other day was given in other 30 cases （experiment group 2）. Postoperative liver function was monitored, and western blot was used to detect changes in autophagy-related protein and apoptotic-related protein expressions. Length of hospital stay was recorded and compared. Results The values of liver function indicators in experiment groups were significantly lower than those in control group, and they were lower in experiment group 2 than those in experiment group 1（P＜0.05＝. The expressions of autophagy proteins in normal liver tissues of experiment group were higher than those in control group （P＜0.05＝, and there were no significant differences in them between experiment group 2 and experiment group 1（P＞0.05）. In experiment group, the expression of apoptosis protein in normal liver tissues was lower than that in control group, and it in experiment group 2 was superior to that in experiment group 1. HE staining showed that there were different degrees of liver cells necrosis and fatty degeneration in control group and experiment group, however, HE staining scores in experiment group 2 were lower than those in experiment group 1 and control group （P＜0.05＝. Length of hospital stay was （16.1±3.8） d in experiment group 1, （15.3±3.1） d in experiment group 2 and （18.0±2.8） d in control group （F=5.428, P＜0.01＝. The hospitalization time in two experiment groups were significantly shorter than that in control group （P＜0.05＝. Conclusion Preoperative application of arginine can induce the expression of autophagy protein, which can alleviate the liver injury in patients with liver resection to a certain degree. Moreover, the interval use of arginine before surgery shows better protective effect for liver function.
文章编号： 中图分类号：R735.7 文献标志码：A
基金项目:徐州医科大学附属医院科技发展基金（XYFY2020045）
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