摘要
目的研究大鼠肝脏热缺血后经门静脉和肝动脉不同时序灌注对其损伤的影响,探索是否可由此减轻大鼠肝脏缺血再灌注损伤及其可能的机理。方法选用健康雄性SD大鼠96只,按随机数字表法等分成6组,1组为假手术组,其余5组为实验组。假手术组(16只)只作开腹和肝门部解剖;实验组(共5组,每组16只)根据再灌注时门静脉和肝动脉不同开放时序分组:先开放门静脉1 min后再开放肝动脉组、先开放门静脉2 min后再开放肝动脉组、先开放肝动脉1 min后再开放门静脉组、先开放肝动脉2 min后再开放门静脉组及同时开放门静脉和肝动脉组。各组分别于术后2 h和4 h检测血清中ALT和AST值,肝组织中丙二醛(MDA)、超氧化物歧化酶(SOD)及谷胱甘肽(GSH)含量变化;采用病理组织切片HE染色观察肝组织损伤情况;TUNEL法检测各组肝组织细胞凋亡情况。结果假手术组大鼠肝脏基本正常,各指标均好于各实验组,差异均有统计学意义(P<0.01)。在各实验组中先开放门静脉1 min后再开放肝动脉组大鼠肝脏缺血再灌注损伤最轻,其ALT、AST、MDA和凋亡指数值均明显低于其他各实验组,差异有统计学意义(P<0.05或P<0.01),并且其SOD和GSH值均高于其他各实验组,差异亦有统计学意义(P<0.05或P<0.01)。肝组织HE染色也显示,先开放门静脉1 min后再开放肝动脉组大鼠肝组织损伤较其他各实验组轻。结论肝脏热缺血后,通过短暂开放门静脉再开放肝动脉的措施可以减轻大鼠肝脏缺血再灌注损伤,可能与降低活性氧的产生及保护肝脏抗氧化系统有关。
Objective To investigate the effects of different reperfusion sequence on hepatic warm ischemiareperfusion injury and its related mechanisms. Methods Ninety-six healthy male Sprague Dawley rats were randomly divided into 6 groups by using random digits method （n= 16, each） ： Sham operation group, only shammed operation for negative control; the other 5 groups were all experimental groups, which were divided according to different reperfusion sequences of portal vein and hepatic artery： reperfusion first through the portal vein for 1 rain with subsequent full reperfusion group, reperfusion first through the portal vein for 2 rain with subsequent full reperfusion group, reperfusion first through the hepatic artery for 1 rain with subsequent full reperfusion group, reperfusion first through the hepatic artery for 2 rain with subsequent full reperfusion group, simultaneous reperfusion through the portal vein and hepatic artery group. Each group was further randomly divided into two subgroups （n=8, each） for sample collection at 2, 4 hours after reperfusion respectively. Serum alanine aminotransferase （ALT）, aspartate aminotransferase （AST） and malondialdehyde （MDA）, superoxide dismutase （SOD） and glutathion （GSH） in hepatic tissue were detected respectively. HE staining of histopathologic slides was used to observe the morphological changes of hepatic tissue. TUNEL method was used to assess the apoptosis index （AI） of hepatocytes. Results The liver of rat was approximately normal in the sham operation group with lower levels of ALT, AST, MDA and AI, and higher levels of SOD and GSH as compared with all the experimental groups （P〈0.01）. Less hepatic ischemia-reperfusion injury was found in reperfusion first through the portal vein for 1 min with subsequent full reperfusion group, whose ALT, AST, MDA and AI levels were significantly lower than those of the other experimental groups （P〈0.05 or P〈0.01）, and its SOD and GSH levels were higher than those of the other experimental groups （P〈0.05 or P〈0.01）. HE staining also showed milder hepatic injury in reperfusion first through the portal vein for 1 min with subsequent full reperfusion group as compared with the other experimental groups. Conclusion Hepatic reperfusion first through portal vein for short time with subsequent full reperfusion could depress the synthesis of free oxygen radicals and suppress apoptosis of hepatocytes, thus relieving hepatic ischemia-reperfusion injury.
出处
《中国普外基础与临床杂志》
CAS
2009年第3期203-207,共5页
Chinese Journal of Bases and Clinics In General Surgery
基金
江苏省"科教兴卫工程"医学重点人才基金(项目编号:RC2007056)~~
关键词
再灌注损伤
肝动脉
门静脉
氧自由基
Reperfusion injury
Hepatic artery
Portal vein
Oxygen radical
