药物和缺血预处理对肝硬化肝脏缺血再灌注损伤的协同保护作用.DOCVIP

临床医学论文-药物和缺血预处理对肝硬化肝脏缺血再灌注损伤的协同保护作用 【摘要】 目的? 探讨阿霉素和缺血联合预处理对肝硬化肝脏缺血再灌注损伤的保护作用及其可能机制。方法? （1）诱导大鼠肝硬化模型;（2）缺血再灌注损伤前3组肝硬化大鼠分别行阿霉素预处理、缺血预处理、阿霉素+缺血联合预处理，比较3组和对照组AST、ALT、LDH和ET、TNF-α、NO、热休克蛋白70（HSP70）差异有显著性。 结果? 阿霉素预处理、缺血预处理、阿霉素+缺血联合预处理能明显抑制AST、ALT、LDH水平升高，其中以阿霉素+缺血联合预处理作用最显著;缺血预处理能显著降低ET、TNF-α水平;阿霉素预处理和缺血预处理使NO显著升高;阿霉素预处理能使肝细胞HSP70显著增加。 结论? 阿霉素和缺血预处理都能减轻肝硬化肝脏缺血再灌注损伤程度;阿霉素+缺血联合预处理对肝硬化肝脏缺血再灌注损伤有协同保护作用。???? 　　关键词? 阿霉素预处理 缺血预处理 肝硬化 缺血再灌注损伤????? 　　Synergetic protective effect of drug and ischemic preconditioning on cirrhosis livers with reperfusion injury????????? 　　【Abstract】 Objective To determine whether pharmacological preconditioning（doxorubicin，DOX）and is-chemic preconditioning（IP）might produce protective effect on rat livers with cirrhosis and its probable mechanism.Methods （1）Induction of cirrhosis model of rats.（2）Before carrying out liver IR injury，3groups of rats were differ-ently preconditioned with IP，DOX and IP+DOX.Then compared the levels of AST，ALT，LDH，NO，ET，TNF-α，HSP70of every group with that of control group，and determine if they had significant difference.Results DOX pre-conditioning and IP significantly decreased serum AST，ALT and LDH，furthermore interaction of DOX preconditioning and IP had statistical significance and associating application of the two methods decrease serum AST，ALT and LDH to a lower level.IP significantly decreased plasma ET and serum TNF-α;DOX and IP significantly increased serum NO;DOX preconditioning improved the expression of HSP70in liver.Conclusion DOX preconditioning and IP have protective effect on liver with cirrhosis against subsequent ischemia-reperfusion injury.Associating application of the two methods may have synergistic protective effect.??? 　　Key words pharmacological preconditioning ischemic preconditioning cirrhosis ischemia-reperfusion in-jury?????? 　　缺血再灌注损伤在肝脏外科领域非常常见，肝切除术中常需夹闭肝十二指肠韧带暂时阻断肝脏血流控制创面大出血，但时间较久将造成肝缺血再灌注损伤，严重者可导致肝功能衰竭。本实验欲探讨阿霉素、缺血预处理对肝硬化缺血再灌注损伤的保护作用及其可能机制。 　　1 材料与方法???? 　　1.1 实验动物及肝硬化模型诱导 （1）