不同预处理对大鼠肝移植供肝保护作用的探讨

目的通过应用缺血、加热等多种手段对大鼠供肝进行移植术前的预处理,比较各种预处理方法对大鼠肝移植供肝缺血再灌注损伤的保护作用。方法将SD大鼠50只,随机分为5组:半肝缺血预处理组、脾脏缺血预处理组、热休克预处理组、热休克 缺血预处理组及手术对照组,分别进行肝脏预处理后行模拟原位肝移植术,术后检测胆汁流量,术后24 h检测血清ALT,AST,ALP水平并观察肝脏形态学变化。结果半肝缺血预处理组、热休克预处理组移植后胆汁分泌量多于对照组,血清ALT,AST水平明显低于对照组(P<0.05); 热休克 缺血预处理组的血清ALT水平低于对照组(P<0．05),胆汁分泌量及血清AST与对照组没有显著差异;脾脏缺血预处理组的胆汁分泌量多于对照组,血清ALT水平低于对照组(P<0．05)。结论肝脏缺血预处理初始阶段保护作用最明显,将缺血及热休克预处理两种方法联合处理大鼠时,其保护作用弱于单独缺血或单独热休克的预处理方法;脾脏缺血预处理也具有保护肝脏的作用。

Discussion on the protective effect of liver preconditioning on liver transplantation in rat

Objective To compare different liver preconditioning methods on the rat model of simulation model of othotopic liver transplantaton. Methods A total of 50 male SD rats were randomly divided into five groups: (1)liver IP group, (2)spleen IP, (3)heat preconditioning, (4)heat preconditioning IP,(5)control group. After the rat othotopic liver transplantation, the bile flow, level of serum transaminase and the morphological changes of the liver were measured. Results The outcome of bile flow, levels of serum ALT,AST level and the morphology of liver were much better in the IP group and the heat preconditioning group than that of the control group (P<0.05) . While the combination of these two methods seemed to attenuate the protection as demonstrated by serum ALT level and the liver histology(P<0.05). The spleen IP also showed the protection against IRI(P<0.05) . Conclusion Protective effects of IP and heating preconditioning are beneficial to the hepatic IRI. But the combination of these two methods seems to attenuate the protection. The spleen IP can also protect the rat liver from IRI.