多参数系统生物传感器Neurotrend-7监测移植早期肝细胞的代谢

背景：目前，各种监测设备已经用于移植肝的早期监测，但没有一种方法能够持续不断的监测移植肝细胞的代谢变化来反映移植肝内部环境的变化情况。 目的：探讨应用多参数系统生物传感器Neurotrend-7持续监测肝细胞代谢，为早期发现移植后肝脏功能不良提供依据。 方法：健康成年雄性日本大耳白兔24只分为3组，对照组(n=4)：开腹仅行肝组织埋入氧代谢监测传感器及标本取材后关腹。两个实验组完成兔肝移植后肝内置入多参数监测仪传感器探针，实验1组(n=10)供肝保存时间< 2 h；实验2组(n=4)供肝保存时间> 4 h。移植前及移植后1，3，5 d连续监测肝组织的pH、氧分压、二氧化碳分压变化并测量动脉血PaO₂、PaCO₂、动脉血气pH值。同时，切取同位点的肝组织行光镜和电镜检查。 结果与结论：实验2组肝组织氧分压显著低于实验1组(P < 0.05)，且随时间逐渐下降；肝组织二氧化碳分压各时段高于实验1组(P < 0.05)，并且随时间逐渐增高；肝组织pH值较实验1组各时间段更低(P < 0.05)，提示肝功能严重不良或移植肝无功能。肝组织氧分压与动脉血PaO₂呈正相关，肝组织二氧化碳分压与动脉血PaCO₂无明显相关性；肝组织pH与动脉血气pH值也无明显相关性。变化与组织学检查相似。提示，多参数系统生物传感器Neurotrend-7可为早期发现移植后肝脏功能不良，观察其演变规律，指导临床早期预防和治疗，为其在肝脏外科和器官移植领域临床应用提供准确的数据支持。

Monitoring of liver cell metabolism in early transplantation with the multi parameter system biosensor Neurotrend-7

BACKGROUND:At present, various monitoring equipments have been used in graft early monitoring, but there is no way to continuous monitoring transplant liver cell metabolic changes to reflect the graft internal environment changes. OBJECTIVE:To explore continuous monitoring of liver cell metabolism with multi parameter system biosensor (Neurotrend-7), and to provide the basis for the liver hypofunction after transplantation in early stage. METHODS:A total of 24 healthy, adult, male, New Zealand, White rabbits were divided into 3 groups: control group, experimental group 1, and experimental group 2. Control group (n=4): They were treated with buried oxygen metabolism monitoring sensor of liver tissue when abdomen was opened, and abdomen was closed, after the specimen drawn. Multi parameter system biosensor probe was inserted into liver after liver transplantation between experimental group 1 and experimental group 2. Ten cases of rabbits underwent the liver transplantation, for the liver retention time was lesser than 2 hours in experimental group 1; 4 cases of rabbits underwent the liver transplantation, for the liver retention time was more than 4 hours in experimental group 2. Before transplantation and 1, 3, 5 days after transplantation, the changes of the pH, PCO₂, and PO₂ value in liver tissue were continually monitored, and PaO₂, PaCO₂, and arterial blood gas (ABG) pH value were measured. At the same time, the liver tissue cut in the corresponding points was observed under the optical microscope and electron microscope. RESULTS AND CONCLUSION:PO₂ value of liver tissue in experimental group 2 was significantly lower than that in experimental group 1 (P < 0.05), and gradually decreased with the time. However, PCO₂ value of liver tissue in experimental group 2 at each time was significantly higher than that in experimental group 1 (P < 0.05), and gradually increased with the time. pH value of liver tissue in experimental group 2 at each time was lower than that in experimental group 1 (P < 0.05). It is indicated that liver function is serious adverse and transplant is non-function. The PO₂ and PaO₂ were positive correlation; however, PCO₂ and PaCO₂ were not obvious relevance. Also, the pH value and ABG pH value were not obvious relevance. Changes are similar to the histology inspection. It suggested that multi parameter system biosensor (Neurotrend-7) can discover liver hypofunction after transplantation at early stage and observes its evolution rule, to guide early prevention and the treatment in clinic, it also can provides the accurate data for clinical application in the liver surgery and organ transplantation field.