摘要
为探讨肝缺血再灌注致急性肺损伤的发病机制 ,采用大鼠部分肝缺血再灌注模型 ,将健康雄性SD大鼠 2 4只随机分为 3组(每组均为 8只 ) :A组 (手术对照组) ,B组 (肝缺血 90min组 ) ,C组 (肝缺血 90min再灌注 12 0min组 )。分别测定血浆中天冬氨酸转氨酶(AST)、丙氨酸转氨酶 (ALT)、乳酸脱氢酶 (LDH)、肿瘤坏死因子 (TNF α)、白介素 1β(IL 1β)和支气管肺泡灌洗液中总蛋白以及肺组织干湿重比的变化 ;观察光镜下肺组织病理变化及各组血压的动态变化。结果显示 :①缺血再灌注各组与对照组比较 ,血浆中ALT、AST、LDH浓度明显升高 ;②肺干湿重比值明显降低 ,支气管肺泡灌洗液中总蛋白含量显著升高 ;③C组血浆TNF α、IL 1β分别为 (1 2 7± 0 6 2 )ng/ml、(0 2 2±0 5 3)ng/ml,与A组比较明显升高(P <0 0 5 ) ;④肝缺血期血压没有明显降低 ,再灌注发生后血压开始下降 ,最低血压与对照组比较有明显差异 (P <0 0 1) ,约 30min后血压回升到正常 ;⑤缺血再灌注后有明显肺泡内和肺间质水肿及炎症细胞浸润。提示肝缺血再灌注后释放细胞因子TNF α、IL
To investigate whether liver ischemia and reperfusion directly affect functions of a remote organ (lung), we reproduced a model of hepatic lobar ischemia and reperfusion in rats. Twenty four healthy male SD rats were randomized into three groups (each group = 8) . Group A served as sham operated control group, group B was subjected to 90 min ischemia of a lobe of the liver, and group C animals underwent 120 min reperfusion, following 90 min ischemia of a liver lobe. In addition to histologic examination of the lung in each group, plasma tumor necrosis factor α(TNF α),interleukin 1β(IL 1β),alanine aminotransferase(ALT), aspartate aminotransferase (AST), lactate dehydrogenase(LDH) levels, total protein content in bronchoalveolar lavage fluid (BALF) and lung dry to wet weight ratio were respectively examined in A, B and C groups. Blood pressures were monitored in each group. Histological manifestations of damage to the lung occured in groups B and group C were characterized by obvious intra alveolar and interstitial edema with inflammatory cellular infiltration. Plasma ALT, AST, LDH, were significantly increased in group C animals ( P <0 01). The protein content of BALF in group B and C animals as compared with that of group A, showed a remarkable elevation; lung dry to wet weight ratios in groups B and C were significantly lower than that of group A. All animals in groups A and B were hemodynamically stable throughout the observation period, whereas the animals in group C became transiently hypotensive within 30 min after hepatic revascularization. The mean minimum systolic pressure for animals in group C was significantly different from that of animals in group A ( P <0 01).The results of this study demonstrate that hepatic ischemia and reperfusion result in local and remote organ (lung) injury in rats, and liver derived TNF α and IL 1β might play an important role in the pathophysiologic alterations after hepatic ischemia and reperfusion.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2002年第3期231-233,共3页
Medical Journal of Chinese People's Liberation Army
基金
全军医学科研"十五"计划基金资助课题 (编号 0 1MB0 76)
