生物人工肝系统治疗对急性肝衰竭犬血清内毒素的影响

Bioartificial liver system for treatment of acute liver failure in canines and the effect on serum endotoxin

目的 探讨生物人工肝 (BAL )系统治疗急性肝衰竭 (ALF )的效果及其与内毒素的关系。方法 采用门腔分流及胆总管结扎切断术建立犬ALF模型。 10只实验动物随机分为两组 ,即BAL治疗组和对照组 (未行BAL治疗组 )。BAL每次循环 5h。检测两组建模前 ,以及循环前后的血清内毒素、谷丙转氨酶 (ALT )和总胆红素 (TB)。结果 治疗组建模前、循环前和循环后血清内毒素分别为 0 .2 84EU /ml ,0 .5 2 6EU /ml ,0 .416EU /ml ;循环前血清内毒素较建模前明显升高 (P <0 .0 5 ) ,循环后又明显降低 (P <0 .0 5 ) ;对照组循环前血清内毒素显著高于建模前 (P <0 .0 5 ) ,循环前后血清内毒素无明显变化 (P >0 .0 5 )。治疗组循环后血清ALT和TB较循环前明显下降 (P <0 .0 5 ) ;对照组循环前后ALT和TB无明显变化 (P >0 .0 5 )。结论 BAL治疗能降低ALF犬血清内毒素含量。

Objective To evaluate the effect of a bioartificial liver (BAL) system for treatment of acute liver failure (ALF) in canines and its relationship to serum endotoxin. Methods ALF was induced by end-side portocaval shunt combined with common bile duct ligation and transection. Ten ALF canines were distributed to BAL group (n=5), or to a control group (n=5). Each BAL circulation lasted 5h. Serum endotoxin, alanine aminotransferase (ALT) and total bilirubin (TB) before establishment of ALF model, pre-circulation and post-circulation were determined. Results Serum endotoxin level was 0.284 EU/ml, 0.526 EU/ml and 0.416 EU/ml before establishment of ALF model, and pre-circulation and post-circulation in BAL group, respectively. The serum endotoxin level in BAL group increased pre-circulation (P<0.05) and decreased post-circulation (P<0.05). Serum endotoxin level in control group increased pre-circulation (P<0.05). There were no significant differences in endotoxin level between pre-circulation and post-circulation in the control group. Serum ALT and TB in BAL group decreased significantly post-circulation compared with pre-circulation(P<0.05). There were no significant differences in ALT and TB level between pre-circulation and post-circulation in the control group. Conclusions BAL treatment can effectively decrease the serum endotoxin level of ALF canines.