高渗盐水预处理可减轻中性粒细胞介导的肝脏缺血再灌注损伤

目的：探讨高渗盐水预处理对肝脏缺血再灌注损伤的拮抗作用及其机制。方法：建立大鼠局部肝脏缺血再灌注模型。设假手术组（sham组）、缺血再灌注组（IR组）和高渗盐水预处理组（HTS组），分别于再灌注后1 h、3 h、6 h、12 h和24 h处死大鼠，测定谷丙转氨酶（ALT）；抗凝血流式细胞仪测定中性粒细胞CD11b/CD18(Mac-1)的阳性率；RT-PCR和Western blotting分别测定肝内细胞间黏附分子1（ICAM-1）的mRNA和蛋白表达；比色法测定肝脏内髓过氧化物酶（MPO）活性；常规病理及电镜观察肝脏的病理学改变及肝脏内中性粒细胞的浸润情况。结果： ① HTS组在3 h、6 h和12 h血清ALT水平明显低于IR组（P<0.05）。②HTS组在6 h和12 h中性粒细胞Mac-1表达显著弱于IR组（P<0.05）。③HTS组肝脏MPO活性在再灌注后6 h、12 h和24 h明显低于IR组（P<0.05）。④HTS组大鼠肝脏内ICAM-1mRNA及蛋白表达明显低于IR组。⑤HTS组肝内中性粒细胞浸润、肝细胞浊肿和肝窦狭窄程度轻于IR组。结论： HTS预处理能够通过抑制中性粒细胞Mac-1和肝内ICAM-1的表达，明显抑制肝内中性粒细胞的黏附和聚集，起到拮抗肝脏缺血再灌注损伤的作用。

Pretreatment of hypertonic saline attenuates the hepatic ischemia reperfusion injury induced by neutrophils

AIM: To explore the effect of the pretreatment of hypertonic saline (HTS) in hepatic ischemia reperfusion (I/R) injury.METHODS: The rats were divided into sham group (sham group), ischemia reperfusion group (IR group) and pretreatment of hypertonic saline group (HTS group). Partial hepatic ischemia reperfusion model was used. The rats were sacrificed at the time of 1 h, 3 h, 6 h, 12 h and 24 h after reperfusion in each group, respectively. Blood samples were obtained to examine ALT. The expression of the CD11b/CD18 (Mac-1) on the neutrophils was analyzed by flow cytometry. RT-PCR and Western blotting were used to examine the expression of intercellular adhesion molecule-1 (ICAM-1) in livers and chromatometry was performed to detect the activity of myeloperoxidase (MPO) in livers. The morphology of hepatocytes and the structure of sinusoid were observed by histological examinations. RESULTS: ① HTS pretreatment decreased the level of ALT at the time points of 3 h, 6 h and 12 h after reperfusion (P<0.05). ② Mac-1 expression in HTS group was lower at 6 h and 12 h after reperfusion compared with IR group (P<0.05). ③ MPO activity in HTS group was lower at 6 h, 12 h and 24 h compared with IR group (P<0.05). ④ RT-PCR and Western blotting analysis indicated that the pretreatment of HTS inhibited the expression of ICAM-1 in livers after reperfusion. ⑤ Moderate hepatocyte swelling and few neutrophil infiltration were observed in HTS group.CONCLUSION: Pretreatment with HTS has the effect on hepatic ischemia reperfusion injury by inhibiting the expression of Mac-1 on circulating neutrophils and the expression of ICAM-1 in the liver.