亲体肝移植患儿围术期血清中脑损伤标志物水平的变化及临床意义

doi:10.13481/j.1671-587x.20210123

Abstract

Abstract: Objective

To investigate the changes in the levels of serum neuron specific enolase （NSE） and serum S-100β protein during the perioperative period in the infants underwent parent liver transplantation， and to clarify the relationships between NSE， S-100β and brain injury during the perioperative period of the infants underwent parent liver transplantation.

Methods

Forty infants with congenital biliary atresia underwent parent liver transplantation were selected， aged 4－12 months， weighing 3.0－10.0 kg， ASA status Ⅲ or Ⅳ class. The blood samples were drawn from central vein of the infants before skin incision （T₁）， 30 min after anhepatic phase （T₂）， 1 h after neohepatic phase （T₃） and 24 h after neohepatic stage （T₄）. Furthermore， the heart rate （HR）， the mean arterial blood pressure（MAP）， the central venous pressure（CVP），and pH values of blood were monitored at the moments of T₁－T₄. The serum S-100β and NSE levels were detected by ELISA method.

Results

The levels of hemodynamics were significantly changed in anhepatic phase and neohepatic phase；compared with T₁，the HR at T₂of the infants was accelerated （P<0.05），and the MAP， CVP and pH value of blood were decreased （P<0.05）. After the surgery， all the hemodynamic indexes fell to the preoperative levels. Compared with T₁， the serum NSE and S-100β levels at T₂－T₄ of the infants were decreased （P<0.05）； compared with T₂， the serum S-100β and NSE levels of the infants at T₃ of the infants were significantly increased （P<0.05）； compared with T₃，the serum S-100β and NSE levels at T₄ of the infants were significantly decreased （P<0.05）.

Conclusion

The brain injury may appear during the perioperative in the infants underwent parent liver transplantation and gradually aggravates during the anhepatic phase and gradually returns to the preoperative levels at 24 h after surgery.

Key words: parent liver transplantation, infant, brain injury, neuron specific enolase, S-100β protein

CLC Number:

R657.3

Hongli YU,Wenli YU,Yiqi WENG,Weihua LIU,Ying SUN,Yunxia LIU. Changes in levels of brain injury markers in serum during perioperative period in infants underwent parent liver transplantation and their clinical significances[J].Journal of Jilin University(Medicine Edition), 2021, 47(1): 168-172.

Figures/Tables 2

References 24

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Time	HR(min^－1)	MAP(P/mmHg)	CVP(P/cmH₂O)	pH
T₁	119.78±12.73	46.13±8.08	4.43±1.41	7.44±0.08
T₂	132.78±14.81^*	41.33±8.18^*	2.95±1.03^*	7.31±0.51^*
T₃	113.58±9.91^*△	49.08±7.89^*△	6.48±1.97^*△	7.38±0.82^*△
T₄	106.68±7.66^*△#	52.68±3.40^*△#	7.40±2.06^*△#	7.42±0.53^△#
F	36.57	17.89	57.72	24.71
P	<0.05	<0.05	<0.05	<0.05

Time	NSE	S-100β
T₁	17.03±2.76	4.03±1.13
T₂	21.36±3.45^*	8.06±2.30^*
T₃	25.15±4.20^*△	9.64±2.49^*△
T₄	18.10±2.94^*△#	6.96±2.99^*△#

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Changes in levels of brain injury markers in serum during perioperative period in infants underwent parent liver transplantation and their clinical significances

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