肝缺血再灌注损伤与细胞凋亡关系的临床研究

目的通过检测肝缺血再灌注前后肝组织的细胞凋亡情况,探讨临床手术中肝缺血再灌注与细胞凋亡之间的关系,为更好地预防或减轻临床肝脏手术中造成的缺血再灌注损伤（HIRI）提供理论基础。方法以细胞凋亡测定法（TUNEL法）测定肝缺血再灌注前后肝细胞的凋亡情况。结果肝门阻断前与肝门开放时和关腹前肝细胞的凋亡指数各组间的差异有统计学意义（P〈0.01）,肝门阻断前肝细胞的凋亡指数高于肝门开放时和关腹前肝细胞的凋亡指数（P〈0.01）;肝门开放时肝细胞的凋亡指数高于关腹前肝细胞的凋亡指数（P〈0.01）。结论研究表明肝脏手术中,在肝细胞短时间（15min左右）缺血后的再灌注损伤中,肝细胞凋亡和缺血再灌注损伤呈负相关,它并不是术后早期肝细胞损伤的一种主要方式。

Relationgship between hepatic ischemia-reperfusion injury and apoptosis

Objective To detect the apoptosis of liver cell before and after hepatic ischemia-reperfusion,and explore the relationship between the liver ischemia-reperfusion of the clinical operation and apoptosis,in order to provide a theoretical basis for better preventing the hepatic ischemia reperfusion injury（HIRI） caused by the operation.Methods The apoptosis determination（TUNEL method） was used to measure the apoptosis index（AI） of hepatic cells before and after liver ischemia reperfusion.Results Compared the AI of hepatic cells before Pringle＇s maneuveur,at the time of the open of porta hepatis and before the closure of abdominal cavity respectively,differences among these three groups were significant（P〈0.01）.The AI of liver cells before Pringle＇s maneuveur was higher than that at the open of porta hepatis（P〈0.01）,and also was higher than that before the abdominal closure（P〈0.01）,AI of liver cells at the time of the open of porta hepatis was higher than the AI before the abdominal closure（P〈0.01）.Conclusion In the early of hepatic reperfusion injury after the short（about 15mins） term ischemia,apoptosis and ischemic reperfusion injury is a negative correlation,apoptosis is not the major way in the early injury of the liver cell.