心肺复苏后大鼠肝细胞凋亡的实验研究

目的研究心肺复苏后大鼠肝细胞的凋亡情况及其可能机制。方法sD雄性大鼠40只，随机分为5组，即对照组（假手术组）以及复苏后3、6、12、24h组，每组各8只。采用窒息合并冰氯化钾停跳液致大鼠心跳骤停-心肺复苏模型，停跳5min后开始心肺复苏，采用TUNEL法观察复苏后肝细胞的凋亡情况，采用免疫组化的方法观察大鼠肝细胞Bcl-2、fas基因的表达情况。结果复苏后3h大鼠肝细胞就有明显凋亡，复苏后6h达到高峰（P〈0．01），24h肝细胞TUNEL仍为高表达；复苏后3h肝细胞Bcl-2有微弱表达，6h表达增加，24h达到高峰；而fas复苏后3h即呈高表达，与对照组比较差异有统计学意义（P〈0．01），之后持续高表达。结论心肺复苏后大鼠存在肝细胞凋亡．其中fas的高表达介导了肝细胞凋亡。

Experimental study on apoptosis of hepatocyte after cardiopulmonary resuscitation in rats

Objective To investigate the apoptosis of hepatocyte and the correlative mechanism after cardiopulmonary resuscitation(CPR)in rats.Methods Cardiac arrest was induced by asphyxiation(succinylcholine)and ice-cold 0.5 mol/L KCl in rats and resuscitation efforts were begun five minutes after arrest.40 male SD rats,were randomly divided into 5 groups:sham(control group);after cardiopulmonary resuscitation rats were allowed to reperfuse spontaneously for 3 h,6 h,12 h and 24 h(n=8,per group).The apoptosis of hepatocyte were assessed by terminal deoxynucleotidyltransferase-mediated dUTP nick endlabeling(TUNEL).fas,bcl-2 protein expression were studied using immunocytochemistry of each group.Result TUNEL-positive hepatocyte could be found singnificantly at 3 hour post-resuscitation and reach the peak at 6 hour post-resuscitation(P<0.05).The expression of bcl-2,fas in the hepatocyte were found and were continuous to induced by CA and CPR.Conclusion Hepatocyte undergo apoptosis after CPR in rats.Apoptosis is one mechanism of hepatocyte injury after CPR.The results of this study demonstrate that the high expression of fas are responsible for the hepatocyte apoptosis.