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供肝缺血预处理对大鼠肝移植缺血再灌注损伤的保护性作用
引用本文:屈新才,王继亮,秦涛,郑启昌. 供肝缺血预处理对大鼠肝移植缺血再灌注损伤的保护性作用[J]. 中国普通外科杂志, 2007, 16(3): 10-244
作者姓名:屈新才  王继亮  秦涛  郑启昌
作者单位:1. 华中科技大学同济医学院附属协和医院,普通外科,湖北,武汉,430022
2. 河南省人民医院,普通外科,河南,郑州,450003
摘    要:目的:探讨供肝热缺血预处理对大鼠供肝冷缺血再灌注(I/R)损伤中的保护作用及其机制。方法:采用SD大鼠建立原位肝移植动物模型,供肝冷缺血期为120 min,受体无肝期16~20min。随机分为3组:假手术组,获取供肝前仅作肝脏周围韧带的解剖;肝移植组,获取供肝前不作肝门阻断;缺血预处理(IPC)组,获取供肝前阻断肝门5min,再灌注5min。术后2,4,24,72h检测血清ALT、抗氧化酶活力、血清NO水平及细胞因子TNF-α。结果:肝移植组及IPC组术后ALT及过氧化物含量均明显高于假手术组,而IPC组低于肝移植组(P﹤0.05),其抗氧化酶活力较移植组明显升高(P﹤0.05); NO水平在IPC术后2,4,24,72h均显著高于假手术组,72h时肝移植组明显高于IPC组及假手术组(P﹤0.05),而IPC组高于假手术组;肝移植组血清中TNF-α释放明显高于假手术组(P﹤0.05);IPC组TNF-α的释放显著低于肝移植组(P﹤0.05)。结论:供肝热缺血预处理对大鼠供肝冷缺血I/R损伤具有明显保护作用;其机制可能是IPC快速提高并稳定了血清中NO水平,降低了炎性细胞因子TNF-a的产生,从而减少移植肝细胞的损害。

关 键 词:肝移植  缺血预处理  缺血再灌注  一氧化氮  肿瘤坏死因子α  鼠科
文章编号:1005-6947(2007)03-0240-05
收稿时间:2005-12-12
修稿时间:2007-01-05

Protective effect of ischemic preconditioning on liver ischemic-reperfusion injury of liver transplant in rats
QU Xin-cai,WANG Ji-liang,QIN Tao,ZHENG Qi-chang. Protective effect of ischemic preconditioning on liver ischemic-reperfusion injury of liver transplant in rats[J]. Chinese Journal of General Surgery, 2007, 16(3): 10-244
Authors:QU Xin-cai  WANG Ji-liang  QIN Tao  ZHENG Qi-chang
Affiliation:(1.Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan 430022, China; 2.Department of General Surgery, Henan Province People′s Hospital,Zhengzhou 450003,China)
Abstract:Abstract:Objective:To investigate the protective effect and mechanism of warm ischemic preconditioning of on liver cold ischemic-reperfusion injury of donor liver in rats. Methods :Male Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, the cold ischemia period and anhepatic phase was 120 min and 16~20 min respectively. Rats were randomly divided into 3 groups: sham-operation group, liver transplantation group, and ischemic pre-conditioning(IP) group. IP was performed with 5-min ischemia followed by 5-min reperfusion. Results:After operation, the serum levels of ALT and superoxide were significantly higher in the groups of liver transplantation and IP group than in the sham-operation group(P﹤0.05), and they were lower in IP group than those in liver transplantation group(P﹤0.05), but activity of anti-oxidase was higher in IP group(P﹤0.05).Plasma NO concentrations were marked higher in the groups of liver transplantation and IP at 2h, 4h, 24h and 72 h after operation than those in sham-operation group (P﹤0.05), and at 72 h were higher in liver transplantation than those in IP and sham-operation group, and higher in IP group than in sham-operation group. Serum TNF-α levels were obviously increased in liver transplantation than those in IP and sham-operation groups (P﹤0.05).Conclusions:Warm IP for donor liver could obviously protect rat liver graft from cold ischemic-reperfusion injury, its mechanism might be that IP can rapidly increase serum NO level, maintain a steady level of serum NO, decrease TNF-α generation from inflammatory cells and thus diminish cellular injury of liver graft.
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