摘要
目的 :研究肝硬化大鼠肝缺血再灌注 (HepaticIscheiaReperfusion ,HIR)损伤的机制。方法 :用 6 0 %四氯化碳 (CCl4 )溶液皮下注射的方法制作肝硬化大鼠模型。随机分为四组 :A组 :假手术组 (6只 ) ,B组 :单纯肠系膜上静脉阻断 (16只 ) ,C组 :肝门阻断 +门腔转流 (16只 ) ,D组 :肝门完全阻断 40min(16只 )。观察丙氨酸氨基转移酶 (ALT)、天门冬氨酸氨基转移酶 (AST)、透明质酸 (HA)、肿瘤坏死因子 (TNF)、7d存活率及肝、肺病理的变化。结果 :B、C、D组的 7d存活率分别为 5 / 10只、8/ 10只、4/ 10只 ;再灌注后 4h血清TNF含量 ,B、C、D组分别为 (0 .6 31± 0 .198)u/ml、(0 .5 96± 0 .2 2 3)u/ml、(0 .789± 0 .371)u/ml,明显高于术前的 (0 .177± 0 .139)u/ml和A组的 (0 .315± 0 .182 )u/ml(P <0 .0 1) ;D组再灌注 4h的AST明显高于C组 (P <0 .0 1) ;C组的AST、ALT显著高于B组 (P <0 .0 5 ) ;同时的HA水平 ,D组明显高于B组 ,C组显著高于A组 (P <0 .0 1) ;肝、肺组织学检查可见肝、肺的病理损害 ,程度以D组最重、B组次之。结论 :门脉淤血是导致肝硬化大鼠HIR损伤乃至死亡的主要原因。
Objective:To investigate the mechanisms of HIR injury in cirrhotic rat liver.Methods:At first,the rats with cirrhotic liver were produced by carbon tetrachloride(CCL4) injected subcutaneously.Then these rats were divided into four groups randomly.Group A(n=6) were made sham operation,only opened their abdomens,not cross-clamped the hepatic hila;In group B(n=16),the superior mesenteric vein was occulded for 40min with arteral and portal hepatic inflow from the spleinic vein maintained.In group C(n=16),extracorporeal portosystemic shunt from portal vein to inferior vena cava was performed to avoid portal venous congestion during pringle's maneuver for 40min .In group D(n=16),total hepatic ischemia with portal venous congestion was induced by pringle's maneuver for 40min.The 7 day survival rate、AST、ALT、HA、TNF and liver、pulmonary histology were observed.Results:The 7 day survival rate of Group B、C、D were separately 50%、80%、40%.The level of TNF in group B、C、D increased significantly 4hr after reperfusion,compared with it (0.177±0.139u/ml)before operation,and in group A(0.315±0.182u/ml)(P<0.01).TNF of Group B、C、D were separately 0.631±0.198u/ml、0.596±0.223u/ml、0.789±0.371u/ml.The level of AST 4hr after reperfusion in group D was higher significantly than it in group C(P<0.01).And AST、ALT of group C were higher than those of group B (P<0.05).HA of group D was higher than group B,C was higher than A significantly,4hr after reperfusion (P<0.01).Liver and lung histology could be found the aspect of injure.Conclusions:The portal venous congestion was the important factor of HIR injury in cirrhotic rat liver.
出处
《中国现代医学杂志》
CAS
CSCD
2001年第2期20-22,共3页
China Journal of Modern Medicine
