缺血后处理对兔肝脏热缺血再灌注损伤的保护

Protective Effect of Ischemia Postconditioning on Hepatic Ischemia-reperfusion Injury in Rabbits

目的探讨缺血后处理对肝脏热缺血再灌注损伤的保护作用。方法阻断肝十二指肠韧带建立兔肝脏热缺血再灌注模型,将30只健康新西兰大耳白兔随机分为假手术(S组)、缺血再灌注(IR组)、缺血后处理(IP组)3组,每组10只。S组只分离肝十二指肠韧带,不阻断;IR组分离并阻断肝十二指肠25min后再恢复灌注;IP组分离并阻断肝十二指肠韧带,于肝脏缺血25min后恢复血灌前阻断、复灌各1min共3个循环进行缺血后处理。观察麻醉诱导后20min(T0)、阻断肝十二指肠韧带25min(T1)、开放30min(T2)、开放1h(T3)、开放2h(T4)、开放4h(T5)血流动力学、谷丙转氨酶(ALT)变化,并检测肝组织中丙二醛(MDA)、超氧化物歧化酶(SOD)变化。结果与IR组比较,IP组T2时HR,T2、T5时SBP及T5时DBP较IR组高;复灌后(T2～T5)血浆ALT明显降低,肝组织中MDA明显下降,而SOD明显升高(P<0.05)。结论缺血后处理可减轻肝脏缺血再灌注损伤。

Objective To investigate the protective effect of ischemia postconditioning on hepatic ischemia-reperfusion injury in rabbits. Methods Thirty New Zealand white rabbits weighting 1.5 - 2.0 kg with either sex were randomly divided into three groups （ 10 for each） ： Group S with shame operation, group IR with reperfusion at 25 minutes after hepatoduodenal ligament blocking, and group IP with ischemia postconditioning before reopening of blocked hepatoduodenal ligament. HR, SBP, DBP and ALT were measured at the time after anesthesia induction（ To ） , at 25 minutes after hepatoduodenal ligament clamping （T1 ） , 30 minutes （T2 ） ,1 h （T3 ） ,2 h （TO ） and 4 h （T5 ） after hepatoduodenal ligament reopening. Malondialdehyde （MDA） and superoxide dismutase （SOD） of hepatic tissue were measured respectively in Group IR and IP. Result Compared with Group IR, HR at T2, SBP at Tz and T5 , and DBP at T5 were significantly higher, and ALT was obviously descending after reperfusion （ at T2 to T5 ） in group IP （ P 〈 0.05 ）. The concentration of MDA was remarkable lower and SOD was significantly higher in group IP than those in group IR （P 〈 0.05）. Conclusion Ischemia postconditioning could protect liver from ischemia-reperfusion injury in some extent.