肝缺血再灌注后肝内血流动力学的变化

Changes of intrahepatic hemodynamics after liver ischemia reperfusion in rats

目的探讨肝脏缺血再灌注(I/R)后肝内分流(IHSF)和功能性肝血流(FHBF)的变化。方法健康雄性SD大鼠1 2只,作右侧颈动脉、颈静脉插管;开腹后,经回结肠静脉作门静脉插管,分别用以输血、输液、给药、留样、检测等。大鼠经部分肝I/R制模后,随机分为2组(每组6只):(1)正常对照组(对照组),术中只分离肝周围韧带,不作肝门阻断及再灌注。(2)缺血再灌注组(I/R组,实验组),进行4 5 m in的肝门阻断及6 0m in的再灌注。然后两组均经门静脉输注D-山梨醇(1 0mmol/L,0.2mL/m in),2m in后同时取颈动脉、门静脉、肝静脉血各1mL。测定门静脉血流量(PVF)、肝动脉血流量(HAF)。计算肝脏山梨醇摄取率、FHBF和IHSF。结果两组PVF,HAF及总肝血流量(THBF)无明显统计学差异;与对照组比较,I/R组肝脏山梨醇摄取率和FHBF减少,IHSF增加(P<0.0 1)。结论肝I/R后,肝内血流动力学变化表现为肝内门-体分流开放,功能性肝血流减少。

Objective To study the changes of intrahepatic shunt flow （ IHSF ） and functional hepatic blood flow （ FHBF ） after liver ischemia reperfusion in rats. Methods 12 healthy male SD rats were anaesthetized and heparinised. The right carotid artery, jugular vein and two distal ileocolic veins were cannulated for blood transfusion, volume compensation, drug infusion, and blood sampling respectively. Rats were randomly divided into 2 groups. Group 1 was the sham operation control group. Group 2 rats was ischmic/reperfusion （ I/R ） group, subjecting to 45min liver lobar ischemia and 60min reperfusion. Both groups received infusion of D-sorbitol （ 10mmol/1,0.2 mL/min ） via portal venous, and blood samples （ 1 mL ） were drawn simultaneously from the carotid, portal venous, and hepatic venous catheters. Portal venous flow （ PVF ） and hepatic arterial flow （ HAF ） were measured via flow probes. Hepatic sorbitol uptake rate, FHBF and IHSF were calculated. Results There were no significant differences between the two groups in PVF, HAF and total hepatic blood flow （THBF）. Compared to control group, hepatic sorbitol uptake rate as well as FHBF were decreased and IHSF was increased in I/R group （ P 〈 0.01 ）. Conclusions After liver ischemia reperfusion in rats, intrahepatic portal systemic shunts were opened and FHBF was reduced.