摘要
目的 研究大鼠胆总管结扎 (bileductligation ,BDL)后肝脏缺血再灌注 (ischemiareperfusion ,I/R)损伤的特点。方法 胆总管结扎后 ,采用常温下第一肝门阻断 15min ,复制肝脏缺血再灌注模型。 96只雄性SD大鼠随机分为正常对照组和胆道梗阻 1、2周组 ,观察I/R后不同时相点肝功能 ,肝窦内皮细胞ICAM 1表达 ,1周生存率以及肝组织的病理变化。结果 I/R后 ,各组的 1周生存率分别为 :8/ 8、7/ 7、5 / 6 ;各组ALT、AST水平在I/R后均升高 ,正常对照组再灌注后 6h达最高值 ,而BDL各组再灌注后 1h水平最高 ,表现为峰值前移 ;再灌注后6hTNFα明显升高超过缺血前水平 (P <0 .0 1) ,SOD水平则明显下降 ;各组肝窦内皮细胞ICAM 1表达变化趋势相同 ,再灌注 1h后明显升高 ,BDL组上升水平明显超过正常对照组 ;肝脏组织学检查 ,I/R后胆道梗阻大鼠可见程度不同的肝细胞变性 ,胞浆疏松 ,肝窦腔变窄 ,中性粒细胞 (PMN)浸润。结论 胆道梗阻大鼠具有 :①在一定的胆道梗阻时段内大鼠可以耐受 15min的肝门阻断 ;②肝窦内皮细胞ICAM 1过量表达加重肝脏I/R损伤 ;③缺血再灌注后ALT。
Objective To investigate the characteristics of hepatic ischemia reperfusion (I/R) injury to rats undergone BDL. Methods The model of hepatic I/R was established by blocking of the porta hepatis of rats at normothermia through bile duct ligation (BDL). 96 male SD rats were randomly divided into control group and BDL1,2 week groups to observe the changes of hepatic function, the expression of ICAM-1 of hepatic sinusoidal endothelical cell(SEC),pathological changes of liver and 1-week survival rate. Results After I/R, the survival rate of 1-week in each group was 8/8、7/7、5/6 respectively. The ALT and AST levels of control group peaked at the 6th hour, while the peak level of BDL 1,2 week group occurred 1 h after I/R. Six hours after reperfusion , the level of TNFa was obviously higher than preoperative(P<0.01), and SOD was decreased significantly. All expression of ICAM-1 was obviously increased after reperfusion 1 hour later.The BDL group was remarkedly higher than control group (P<0.01). There was histologic evidence of liver injury following I/R such as hepatocyte degeneration, PMN accumulation and so on. This change aggravated with increasing cholestasis, as compared with control group. Conclusion The findings suggest that the rats can safely tolerate blocking of porta hepatis for 15 min during cholestasis at definite period;over expression of ICAM-1 of hepatic SEC may worsen the injury to liver of I/R and the peak of ALT, AST may advance.
出处
《皖南医学院学报》
CAS
2003年第4期244-247,共4页
Journal of Wannan Medical College
基金
安徽省教育厅自然科学基金 (编号 2 0 0 2kj3 14 )资助
