生物人工肝系统治疗对急性肝衰竭犬血清内毒素的影响

目的　探讨生物人工肝 (BAL )系统治疗急性肝衰竭 (ALF )的效果及其与内毒素的关系。方法　采用门腔分流及胆总管结扎切断术建立犬ALF模型。 10只实验动物随机分为两组 ,即BAL治疗组和对照组 (未行BAL治疗组 )。BAL每次循环 5h。检测两组建模前 ,以及循环前后的血清内毒素、谷丙转氨酶 (ALT )和总胆红素 (TB)。结果　治疗组建模前、循环前和循环后血清内毒素分别为 0 .2 84EU /ml ,0 .5 2 6EU /ml ,0 .416EU /ml ;循环前血清内毒素较建模前明显升高 (P <0 .0 5 ) ,循环后又明显降低 (P <0 .0 5 ) ;对照组循环前血清内毒素显著高于建模前 (P <0 .0 5 ) ,循环前后血清内毒素无明显变化 (P >0 .0 5 )。治疗组循环后血清ALT和TB较循环前明显下降 (P <0 .0 5 ) ;对照组循环前后ALT和TB无明显变化 (P >0 .0 5 )。结论　BAL治疗能降低ALF犬血清内毒素含量。

Bioartificial liver system for treatment of acute liver failure in canines and the effect on serum endotoxin

Objective To evaluate the effect of a bioartificial liver (BAL) system for treatment of acute liver failure (ALF) in canines and its relationship to serum endotoxin. Methods ALF was induced by end-side portocaval shunt combined with common bile duct ligation and transection. Ten ALF canines were distributed to BAL group (n=5), or to a control group (n=5). Each BAL circulation lasted 5h. Serum endotoxin, alanine aminotransferase (ALT) and total bilirubin (TB) before establishment of ALF model, pre-circulation and post-circulation were determined. Results Serum endotoxin level was 0.284 EU/ml, 0.526 EU/ml and 0.416 EU/ml before establishment of ALF model, and pre-circulation and post-circulation in BAL group, respectively. The serum endotoxin level in BAL group increased pre-circulation (P<0.05) and decreased post-circulation (P<0.05). Serum endotoxin level in control group increased pre-circulation (P<0.05). There were no significant differences in endotoxin level between pre-circulation and post-circulation in the control group. Serum ALT and TB in BAL group decreased significantly post-circulation compared with pre-circulation(P<0.05). There were no significant differences in ALT and TB level between pre-circulation and post-circulation in the control group. Conclusions BAL treatment can effectively decrease the serum endotoxin level of ALF canines.