Effects of extremity ischemic preconditioning on liver injury after cardiac valve replacement with cardiopulmonary bypass
10.3760/cma.j.issn.0254-1416.2015.09.002
- VernacularTitle:肢体缺血预处理对CPB下心脏瓣膜置换术患者肝损伤的影响
- Author:
Yanchao LI
;
Huiwei DENG
;
Xincheng MAO
;
Guoguang ZHANG
;
Weidong FU
;
Daobo PAN
- Publication Type:Journal Article
- Keywords:
Ischemic preconditioning;
Lower extremity;
Cardiopulmonary bypass;
Heart valve prosthesis implantation;
Liver injury
- From:
Chinese Journal of Anesthesiology
2015;35(9):1041-1043
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of extremity ischemic preconditioning on liver injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA physical status Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ), weighing 44-72 kg, with ejection fraction≥40％, schedule for elective cardiac valve replacement with CPB, were randomly divided into 2 groups (n =30 each) using a random number table: control group (group C) and extremity ischemic preconditioning group (group E).Immediately after anesthesia induction, an auto-inflatable cuff was placed under the right lower extremity, and was inflated to 300 mmHg to induce ischemia (oxygen saturation at the finger tip undetected or foot pulse untouched on the operated side) which was preceded by 3 cycles of 5 min ischemia-5 min reperfusion in group E.Before anesthesia induction (T0) , and at 2, 12, 24, and 72 h, and 7 days after operation (T1-5) , blood samples were taken from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities.The expression of serum miR-122 was detected at T0-4 by real-time reverse transcriptase polymerase chain reaction.Results Compared with the value at T0, the serum ALT and AST activities were significantly increased at T2-4, and the expression of miR-122 was up-regulated at T1-3 in the two groups (P＜0.05).Compared with group C, the serum ALT and AST activities were significantly decreased at T2-4, and the expression of miR-122 was down-regulated at T1-3in group E (P＜0.05).Conclusion Extremity ischemic preconditioning can mitigate liver injury after cardiac valve replacement with CPB.
