维拉帕米对大鼠肝脏低温保存再灌注损伤防护机制.doc

维拉帕米对大鼠肝脏低温保存再灌注损伤防护机制 　 作者：高昌俊，李开宗 ，管文贤 【关键词】 肝移植 　　关键词: 肝移植;维拉帕米;器官保存;再灌注损伤 　　摘 要:目的 在自制的器官保存液XJ-1液已取得较好结果的基础上，探讨维拉帕米对大鼠肝脏低温保存再灌注损伤的防护作用及其机制. 方法 XJ-1液与XJ-1+维拉帕米液保存大鼠肝脏18h后施行肝脏移植，检测术后血清转氨酶水平、肝组织钙离子及丙二醛含量等指标，观察大鼠术后1wk存活率及移植肝脏的组织病理学改变. 结果 XJ-1+维液保存的大鼠肝脏移植后4h，血清ALT，AST水平、肝组织钙离子含量、丙二醛含量均显著低于XJ-1液组（Plt;0.01，Plt;0.05），光镜与电镜下肝组织形态学改变较XJ-1液组好，同时术后生存状况及1wk存活率也优于XJ-1液（71%vs57%）. 结论 维拉帕米能够减轻肝脏体外保存再灌注损伤，明显增强了XJ-1液对大鼠肝脏的保存效果，原因在于其阻滞钙通道的钙离子拮抗作用. 　　Protective mechanism of verapamil on rat liver grafts under cold preservation and reperfusion 　　GAO Chang-Jun ，LI Kai-Zong，GUAN Wen-Xian 　　1 Department of Anesthesiology，Tangdu Hospital，Fourth Military Medical University，Xi’an710038，China，2 Department of Hepatobiliary Surgery，Xi-jing Hospital，Fourth Military Medical University 　　Keywords:liver transplantation;verapamil;organ preserva-tion;reperfusion injury 　　Abstract:AIM To investigate the protective effect of vera-pamil on rat liver grafts under cold preservation and reperfu-sion and its mechanism on the basis that we had achieved good effects on rat liver preservation using self-designed XJ-1solution.METHODS Rat orthotopic liver transplants were performed with livers preserved for18h in XJ-1solution and XJ-1+V solution.Serum ALT，AST levels and liver tissue concentrations of calcium and malondialdehyde（MDA）were measured.Histological changes of liver were studied.The rats status and1-week survival rates after transplantation were observed.RESULTS The levels of serum ALT，AST，concentrations of Ca2+ and MDA were significantly lower in XJ-1+V solution group than those in XJ-1solution group at4h after transplantation（Plt;0.01，Plt;0.05）.Histological-ly，livers of XJ-1+V solution group showed less damage，and1-week survival rate was higher compared with that of XJ-1solution group（71%vs57%）.CONCLUSION Vera-pamil can reduce preservation and reperfusion injury，and im-prove the effects of XJ-1solution on rat liver preservation due to its Ca2+ channel blocking effects. 　　0 引言 　　肝移植术后