The Protective Effect Of Sevoflurane On Pig Liver Injury In Hemorrhagic Shock

Objective：To investigate the protective effects and underlying mechanisms ofsevoflurane on Bama minipig’s liver injury in hemorrhagic shock in.Methods：32heads Bama minipigs were randomly divided into4groups（n=8）:hemorrhagic shock group (group HS),control group (group S), sevofluranepreconditioning group (group Pre/Sev) and sevoflurane post-treatement group(group Post/Sev). Fasted8h and free drinking. Established the hemorrhagicshock model after anesthesia in group HS; In group Pre/Sev, Bama minipigswere given2%sevoflurane30min before establishing the model of hemorrhagicshock; In group Post/Sev, Bama minipigs were given2%sevoflurane30minafter Establishing the model of hemorrhagic shock. Blood samples forBHMT, ALT,Lac,IL-6,and TNF-α measurements were collected during thefollowing time points: Before experiment (T0),30min after shock (T1),1h aftershock (T2),1.5h after shock (T3),2h after shock (T4),3h after shock aftershock (T5) and4h (T6). The liver histopathological changes were analyzed byHE staining4h after shock.Results：1. There were no significant differences of Bama minipigs’gender, height, weight, body surface area and bleeding in the four groups(P>0.05).2. HE staining revealved that the structure of liver in group S was regularly,the central of acini hepatis is no hyperemia; liver cell cytoplasm is evenly stained, The nucleus are moderate staining and no enrichment of nuclear. Ingroup HS, the deformation vacuole was found in the central of acini hepatis andmost of the liver cells became necrosis and hyperchromatic, there were a largenumber of inflammatory cells infiltration in portal area. Ingroup Pre/Sev and group Post/Sev, the liver cell edema, infiltration ofinflammatory cells in portal area were less than group HS.3. The changes contention of serum BHMT: Compared with group S, the serumBHMT contentions were significantly increased at T3~T6in group HS,Pre/Sevand Post/Sev (P<0.05). Compared with group HS, the serum BHMT contentionsof group Pre/Sev and Post/Sev were significantly reduced at T3~T6(P<0.05).There was no significant difference in serum BHMT contention at each timepoint between group Pre/Sev and group Post/Sev (P>0.05).4. The changes contention of serum ALT: Compared with group S, the serum ALTcontentions were significantly increased at T4~T6in group HS,Pre/Sev andPost/Sev (P<0.05). Compared with group HS, the serum ALT contentions ofgroup Pre/Sev and Post/Sev were significantly reduced at T4~T6(P<0.05).There was no significant difference in serum ALT contention at each time pointbetween group Pre/Sev and group Post/Sev (P>0.05).5. The changes contention of serum IL-6: Compared with group S, the serum IL-6contentions were significantly increased at T3~T6in group HS,Pre/Sev andPost/Sev (P<0.05). Compared with group HS, the serum IL-6contentions ofgroup Pre/Sev and Post/Sev were significantly reduced at T3~T6(P<0.05).There was no significant difference in serum IL-6contention at each time pointbetween group Pre/Sev and group Post/Sev (P>0.05).6. The changes contention of serum TNF-α: Compared with group S, the serumTNF-α contentions were significantly increased at T2~T6in group HS,Pre/Sevand Post/Sev (P<0.05). Compared with group HS, the serum TNF-α contentionsof group Pre/Sev and Post/Sev were significantly reduced at T2~T6(P<0.05).There was no significant difference in serum TNF-α contention at each timepoint between group Pre/Sev and group Post/Sev (P>0.05). 7. The changes contention of serum Lac: Compared with group S, the serum Laccontentions were significantly increased at T2~T6in group HS,Pre/Sev andPost/Sev (P<0.05). Compared with group HS, the serum Lac contentions ofgroup Pre/Sev and Post/Sev were significantly reduced at T2~T6(P<0.05).There was no significant difference in serum Lac contention at each time pointbetween group Pre/Sev and group Post/Sev (P>0.05).8. There was positive correlation betweent BHMT and ALT (R2=0.804， P<0.05）.9. There was positive correlation between the proinflammatory cytokine level（TNF-a and IL-6）and the liver dysfunction（BHMT andALT）(R2=0.5930.405，R2=0.870,0.922, P<0.05）Conclusion:1. To some extent, sevoflurane could reduce Bama minipigs’ liver injury inducedby hemorrhagic shock;2. This protective effect of sevoflurane is likely related to inhibition of the hemorrhagicshock-induced inflammatory or stress response.3. There is a good correlation between the ALT and BHMT for detecting the liverinjury induced by hemorrhagic shock.