一氧化氮和内皮素在无心跳供肝体外灌流中的作用

目的 利用无心跳供肝体外灌流系统（ECLP）来探讨NO和ET在肝脏缺血再灌注损伤中的作用机制。为有效利用无心跳供肝提供理论依据。方法 实验动物为普通健康的天津白猪，体重在20-25kg，雌雄不拘。按保存方法不同随机分为两组，再根据不同的阶段进行设计。A组（n=4）用HTK液低温保存10h；B组（n=4）用ECLP系统常温灌流10h。经过60min冷缺血期后，连接ECLP系统灌流4h。观察灌流后1、2、3、4h四个时间点灌流液中NO^-2／NO^-3、ET-1水平。结果 B组（ECLP系统灌流组）肝脏在1，2，3，4h四个时间点灌流液中ET-1水平均低于A组，NO^-2／NO^-3则高于A组，两组差异有统计学意义（P〈0．05）。结论 NO和ET在肝脏缺血再灌注损伤中起着非常重要的作用，利用ECLP系统灌流无心跳供肝能够抑制由此造成的NO合成降低和ET的分泌增多，从而改善NO和ET的平衡关系，改善肝脏的微循环障碍和降低肝细胞的损伤。

The role of nitric oxide and endothelin in extracorporeal liver perfusion of NHBD livers

Objective To observe the role of nitric oxide and endothelin in extracorporeal liver perfusion of NHBD livers,and to investigate the mechanism of ischemia-reperfusion injury of non-heart-beating livers.Methods Livers were harvested from health pigs,which were preserved for 10hr by either cold storage in HTK solution(A group,n=4) or by perfusion with oxygenated autologous blood at body temperature(B group,n=4).Both groups were then tested on the circuit for a 4 hr reperfusion phase.The level of NO,ET in the blood for reperfusion were measured.Results At each time point,the levels of NO in the blood for reperfusion in group B were statisti cally higer than that of in group A(P<0.05),but the levels of ET were lower than those of in group A(P<0.05 or P<0.01).Conclusion The unbalance between the NO and ET play an important role in the development of ischemia-reperfusion injury of NHBD liver,extracorporeal liver perfusion can improve the balance between NO and ET,which can reduce the ischemia-reperfusion injury of the NHBD livers.