基础研究再灌注损伤对大鼠术后剩余肝脏的影响.pdfVIP

·332 · doi 10.3969/j.issn. 1673-4254.2013.03.05 J South Med Univ, 2013, 33(3): 332-337 基础研究 淤血淤血//再灌注损伤对大鼠术后剩余肝脏的影响再灌注损伤对大鼠术后剩余肝脏的影响 谭晓宇，许文犁，葛新兰，李崇辉，张爱群，董家鸿 解放军总医院肝胆外科//全军肝胆外科研究所，北京 100853 摘要：目的观察淤血/再灌注损伤（CRI）与缺血/再灌注损伤（IRI）对术后剩余肝脏的影响。方法 将雄性SD 大鼠分为3 组，IRI 组：预先对肝左叶进行30 min 入肝血流阻断，然后切除除左叶以外的其他肝叶（切除部分约占全肝重的70%）；CRI 组：预先对肝 左叶进行30 min 出肝血流阻断，然后切除除左叶以外的其他肝叶；对照组：单纯切除除肝左叶以外的其他肝叶。记录各组大鼠 死亡率，分别于术后1、3、7 d 处死实验大鼠检测各组的ICG 血浆消除率（ICG-PDR）、ALT、AST、肝再生度、Ki-67 标记指数等变 化。结果 CRI组术后死亡率高于IRI 组（34.3% vs8% ，P0.05）以及对照组（34.3% vs4% ，P0.01）；与对照组相比较，CRI组术后 第1天转氨酶明显升高、肝功能显著降低（P0.05），而同等时间的IRI 无统计学差异（P0.05）；与对照组相比，CRI 组的术后第1 天的Ki-67标记指数明显降低（P0.01），甚至低于IRI 组（P0.01）；CRI组的Ki-67标记指数峰值延迟出现，峰值的高度低于对照 组。相比对照组，CRI 组术后第3 天的肝再生度也受到抑制（P0.01），亦低于IRI 组（P0.05）。结论 与IRI 相比，CRI 能引起更 严重的肝损伤同时抑制肝切除术后早期的肝再生。 关键词：淤血/再灌注；缺血/再灌注；肝切除；肝损伤；肝再生 Influences of congestion/reperfusion injury on remnant liver in rats after hepatectomy TAN Xiaoyu, XU Wenli, GE Xinlan, LI Chonghui, ZHANG Aiqun, DONG Jiahong Department of Hepatobiliary Surgery, General Hospital of PLA; Institute of Hepatobiliary Surgery of PLA, Beijing 100853, China Abstract: Objective To observe the effect of congestion/reperfusion injury (CRI) and ischemia/reperfusion injury (IRI) on remnant liver in rats after hepatectomy. Methods Male SD rats were divided into IRI, CRI, and control groups. In the former two groups, the left lateral lobe of the rats were subjected to IRI or CRI for 30 min with the rest lobes (about 70% of the total liver weight) resected; the rats in the control group received hepatectomy preserving only the left lateral lobe. The mortality rate of the rats was recorded, and the surviving rats were sacrificed at 1, 3 and 7 days after operation for analyses of ICG plasma disappearance rate (ICG-PDR), ALT, AST, liver regeneration rate, and Ki-67 labeling index. Results The mor