血小板激活因子拮抗剂E5880在肝切除时对肝脏缺血再灌注损伤的保护作用.DOCVIP

临床医学论文-血小板激活因子拮抗剂E5880在肝切除时对肝脏缺血再灌注损伤的保护作用 ????????? 作者：顾梅 张昆鹏 高峡 朱长雨 关炳星 张娜 【摘要】? 目的 探讨血小板激活因子(plateletactivating factor，PAF)拮抗剂E5880在肝脏血流完全阻断下行70%肝切除术中的肝脏保护作用。方法 实验用家兔16只，分成2组。A组：术前无任何预处理，在Pringle法阻断肝脏血流20 min下行70%肝切除；B组：术前用E5880(0.3 mg/kg)行预处理，在Pringle法阻断肝脏血流20 min下行70%肝切除。肝脏再灌注后评估两组动物肝脏功能。结果 B组7 d存活率较A组显著提高(38% vs 0，P0.05)；肝脏再灌注1 h和4 h时，B组血清AST、ALT、mAST、LDH的升高明显被抑制；B组门静脉压和肝脏能荷较A组有明显改善；A、B组肝动脉和门静脉血液中内皮素1水平均明显升高。B组的肝脏白细胞浸润明显减少。结论 术前使用E5880预处理，可以保护在Pringle法阻断肝脏血流20 min下行70%肝切除术后肝脏功能。 【关键词】? 血小板激活因子； E5880； 肝切除； 缺血再灌注损伤 ???? 【Abstract】? Objective? To study the protective effect of plateletactivating factor (PAF) antagonist E5880 on liver in 70% hepatectomy with total hepatic blood flow occlusion. Methods? A total of 16 rabbits were equally divided into 2 groups: Group A (rabbits received total hepatic blood flow occlusion for 20 minutes by the Pringle′s maneuver plus 70% hepatectomy without pretreatment) and Group B (rabbits pretreated with PAF antagonist E5880 at 0.3 mg/kg and then underwent total hepatic blood flow occlusion for 20 minutes by Pringle maneuver plus 70% hepatectomy). The remnant liver functions in both groups were evaluated after reperfusion. Results? The 7day survival rate of rabbits in Group B was significantly higher than that in Group A (38% vs 0, P0.05). The elevations of serum enzymes of liver (AST, ALT, mAST, and LDH) were significantly inhibited in Group B at 1 and 4 hours after reperfusion. Compared with Group A, the portal venous pressure and the energy charge of liver were significantly improved in Group B. Endothelin1 levels of arterial and portal venous blood increased in Groups A and B. Infiltration of leukocytes into the liver was significantly inhibited in Group B. Conclusions? Pretreatment with PAF antagonist E5880 has protective effect on liver after 70% hepatectomy with total hepatic blood flow occlusion for 20 minutes by Pringle maneuver in rabbits. ??? 【Key words】? Plateletactivating factor;? E5880;? Hepatectomy;? Ischemi