乌司他丁联合17β雌二醇对大鼠肝脏缺血再灌注损伤保护作用的实验研究

Experimental Study on Protective Effect of Pretreatment with Ulinastatin Combined with 17-beta-estradio on Liver Ischemic Reperfusion Injury in Rats

目的探讨乌司他丁联合17β雌二醇预处理对大鼠肝脏缺血再灌注损伤的保护作用。方法将60只健康雄性SD大鼠随机等分为五组:假手术组(A组)、缺血再灌注组(B组)、乌司他丁预处理组(C组)、17β雌二醇预处理组(D组)和乌司他丁联合17β雌二醇预处理组(E组)。采用Pringle法阻断入肝血流30分钟,检测再灌注5小时后血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)和肿瘤坏死因子-α(TNF-α)含量并观察肝组织病理学改变。结果B、C、D和E组血清中ALT、AST、LDH和TNF-α含量明显高于A组(P<0.01);C、D和E组明显低于B组(P<0.01);C组和D组明显高于E组(P<0.05);C组和D组之间无明显差别(P>0.05)。肝组织病理学损害B组最重,C、D组次之,E组最轻。结论乌司他丁、17β雌二醇预处理对大鼠肝脏缺血再灌注损伤具有保护作用,两药联合应用效果更好。

Objective To investigate the protective effect of pretreatment with ulinastatin combined with 17 -beta -estradio on liver ischemic reperfusion injury in rats. Methods Sixty healthy male SD rats, weighing between 220 - 260g, were randomly divided into five groups ： sham - operation group （ A, n = 12）, ischemia - reperfusion group （ B, n = 12）, pretreatment with ulinas- tatin group （C, n = 12）, pretreatment with 17 - beta - estradio group （D, n = 12）, and pretreatment with ulinastatin combined with 17 - beta - estradio （ E, n = 12） . Hepatic inflow was occluded for 30 minutes by pringle＇s maneuver to establish HIRI rat model. The animals were killed 5 hours after reperfusion. The concentrations of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, lactate dehydrogenase （LDH） and tumor necrosis factor- α （TNF- α） in serum were measured, and the histopathological changes of liver were also observed . Results Serum concentrations of ALT, AST, LDH and TNF - α in group B, C, D and E were significantly higher than those in group A （P〈0.01） . In group C, D and E , significantly lower than in group B （ P 〈 0.01 ） . In group C and D, significantly higher than in group E （ P 〈 0. 05） . There was no difference between group C and D （ P 〉 0.05） . And the histopathological change of liver in group B was the severest, group C and D were better than group B, group E was the slightest. Conclusions Pretreatment with ulinastatin or 17 - beta - estradio can protect liver from ischemia reperfusion injury to some extent, and ulinastatin combined with 17 - beta - estradio should give better effects.