前列腺素E1对大鼠肝热缺血再灌注期微循环的影响

目的 研究肝热缺血再灌注（I/R）期微循环变化及前列腺素E1（PGE1）对肝微循环的保护作用,并探讨门静脉途径给药改善肝微循环的可行性。方法 选择Wistar大鼠20只,随机分为实验组和对照组,按Misra法建立肝原位热I/R模型,通过倒置显微镜活体观察模型复制前、后,再灌注前、后以及经门静脉给药后肝中央静脉的管径、血流变化、肝窦开放数,并进行血清生化检测及肝组织病理检查。结果①肝热缺血恢复再灌注后肝中央静脉直径较复制模型前明显变窄（P<0.05）,血流速度明显减慢（P<0.05）,肝窦开放数明显变少（P<0.01）,肝窦血流速度明显减慢（P<0.01）;②热I/R期用药后肝中央静脉管径较用药前明显增宽（P<0.05）,肝中央静脉血流速度实验组较对照组明显增快（P<0.05）,肝窦开放数、血流速度、扩张程度实验组均优于对照组（P<0.01）;③血清生化指标实验组好于对照组（P<0.05）;④病理检查:实验组肝窦扩张、肝窦开放数好于对照组,肝细胞浊肿变性或坏死轻于对照组（P<0.05）。结论①肝脏热I/R期存在严重的微循环障碍和再灌注损伤;②PGE1能有效地改善肝热I/R期的微循环障碍,保护肝微循环,减轻肝组织再灌注损伤;③活体再灌注期经门静脉途经给药对改善肝微循环效果确切、可行。

Effects in vivo of PGE1 on hepatic microcirculation during reperfusion after thermal ischemia in rats

Objective To investigate changes of hepatic microcirculation in thermal ischemia reperfusion period (I/R) , protective effect of prostaglandin E, (PGE,) on microcirculation and feasibility of administration through portal vein in order to improve the microcirculation. Methods Twenty Wistar rats were randomly divided into experimental group and control group. The model of orthotpic liver thermal I/R was established with Misra method. We investigated under inverted microscope the changes in caliber of the central veins, blood flow in them and the number of dilated sinusoids before and after the model was made, during reperfusion period and after administration of PGE1. Biochemical parameters and histopathology were also examined. Results 1. The veinous diameters, blood flow into terminal hepatic venules, the number of dilated sinusoids and blood flow into sinusoids were considerably decreased in I/R of modeled rats than those before the model was established (P < 0. 05 , P < 0. 01 respectively). 2. The caliber and blood flow into terminal hepatic venules in the experimental group were remarkably increased on administration of PGE1 in I/R than those in the controls ( P < 0. 05 ). The number and extent of dilated sinusoids and blood flow into sinusoids in experimental group were significantly increased after administration of PGE, in I/R than those in control group (P <0. 01). 3. Biochemical parameters were improved in experimental group than those in control group ( P < 0. 05 ) . 4. Pathologically, the number of dilated sinusoids was greater in experimental group than that in control group ( P < 0. 05 ). Cloudy swelling degeneration and necrosis of liver cells in experimental group were slighter than those in control group ( P < 0. 05 ). Conclusions 1. There were sevre microcircu-latory dysfuntion and reperfusion injury in hepatic thermal I/R. 2. PGE[ could effectively protect microcirculation and improve reperfusion injury in thermal I/R. 3. Administration of drugs via portal vein could definitely improve hepatic microcirculation in vivo I/R period and portal administration of drug was feasible.