肝缺血-再灌注损伤中脂质过氧化反应及左旋精氨酸的干预作用

目的 :探讨脂质过氧化反应在肝缺血再灌注损伤中的作用及左旋精氨酸对其的影响。方法 :实验兔和肝癌手术患者均随机分为肝缺血再灌注组 (n=10 )和肝缺血再灌注 +左旋精氨酸治疗组 (n=10 ) ;分别取缺血前、缺血 4 5 min(兔 )或 2 5 min(患者 )和再灌注 4 5 m in(兔 )或 2 5 m in(患者 )共 3个时间点 ,用硫代巴比妥酸法测定血浆丙二醛 (MDA) ,赖氏法检测丙氨酸转氨酶 (AL T)。结果 :肝缺血再灌注期间 ,实验兔和肿瘤手术患者血浆 MDA和 AL T均明显升高 ,尤以再灌注 4 5 m in(兔 )或 2 5 min(患者 )为著 (P<0 .0 5或 P<0 .0 1)。左旋精氨酸可逆转上述指标 ,缺血时兔 MDA虽降低 ,但 P>0 .0 5 ;AL T,P<0 .0 5 ;患者 MDA和 AL T均 P<0 .0 1。再灌注时兔 MDA和 AL T均 P<0 .0 1;患者 MDA和 AL T也均 P<0 .0 1。结论 :脂质过氧化反应在肝缺血再灌注损伤发生、发展中起重要的作用 ,左旋精氨酸通过拮抗脂质过氧化反应而减轻肝缺血再灌注损伤。

Role of lipid peroxidation in hepatic ischemia-reperfusion injury and effect of L-Arginine

Objective:To study the role of lipid peroxidation during hepatic ischemiareperfusion injury (HIRI) and the effects of LArginine(LArg).Methods:The rabbits and patients who underwent elective hepatic surgery were randomly divided into two groups respectively,HIRI group and LArg group.Plasma malondialdehyde (MDA) and alanine aminotransferase (ALT) were measured before ischemia 45 minutes (rabbits) or 25 minutes(patients) and 45 minutes (rabbits) or 25 minutes(patients) after reperfusion. Results: As compared with preischemia,MDA and ALT increased during ischemia 45 minutes (or 25 minutes) in rabbits and patients, P <0 05 or P <0 01.Treatment with LArg could markedly reduce the elevation of mentioned biochemical parameters during hepatic ischemia.In rabbits MDA decreased on hepatic but the differents were not significant ( P >0 05),ALT decreased( P <0 05).In patients MDA and ALT both decreased on hepatic(both P <0 01). After reperfusion,MDA and ALT all decreased in rabbits and patients (all P <0 01). Conclusion: These data suggest that lipid peroxidation can play an important role in the happening and developing of HIRI.Treatment with LArg may attenuate ischemiareperfusion injury by antagonizing lipid peroxidation.