TIPSS前后自由基变化的实验研究

目的：测定ＴＩＰＳＳ前后犬肝组织丙二醛（ＭＤＡ）和犬静脉血超氧化物歧化酶（ＳＯＤ）的变化，分析ＴＩＰＳＳ术后氧自由基变化与肝性脑病的关系。方法：选杂种狗１８只，分别在ＴＩＰＳＳ术前、术后５ｍｉｎ和６０ｍｉｎ抽取颈静脉血测ＳＯＤ，另在上述时间点取肝组织测ＭＤＡ值并行镜检。结果：血ＳＯＤ值术前为１０６６．８０±９０．１４Ｕ／Ｌ，术后５ｍｉｎ下降至９４８．００±５２．５１Ｕ／Ｌ，术后６０ｍｉｎ下降到７４９．３０±７４．９３Ｕ／Ｌ（Ｐ＜０．００１）。而ＭＤＡ术前为１．２９±０．０４ｎｍｏｌ／ｍｇ（ｐｒ），术后５ｍｉｎ上升到１．６４±０．１２ｎｍｏｌ／ｍｇ（ｐｒ），术后６０ｍｉｎ上升到１．８８±０．１０ｎｍｏｌ／ｍｇ（ｐｒ）（Ｐ＜０．００１）。肝组织中有白细胞浸润，肝细胞浊肿变性及点状坏死。结论：ＴＩＰＳＳ术存在着肝脏缺血再灌注损伤病理，是ＴＩＰＳＳ术后肝性脑病发生的原因之一

Experimental study of free radical change before and after TIPSS

Objective:To study the relationship between free radical and hepatic encephalopathy after TIPSS by examing MDA in hepatic tissue and SOD in blood.Methods:18 hybrid dogs were prepared.The SOD levels in jugular veins were detected preoperatively,and 5 and 60 min after TIPSS.At the same time MDA contents in hepatic tissue were examed.Results:Preoperative blood SOD level was 1 030.7±205.3 U/L,and it decreased to 989.50±38.79 U/L at 5 min after operation,and to 861.67±34.37 U/L at 60 min after operation.(P<0001) whereas,the postoperative hepatic MDA content increased to 1.45±0.007 nmol/mgpr at 5 min after operation and to 1.63±0.08 nmol/mgpr at 60 min after operation from preoperative 1.33±0.05 nmol/mgpr (P<0001).Microscopically pathological changes in hepatic tissue included leukocyte infilltration,cloudy swelling degeneration and spotty necrosis.Conclusion:Ischemia and reperfusion injury occurred in canine livers during and after TIPSS,which is one of principal causes leading to the hepatic encephalopathy.