银杏内酯对大鼠移植肝缺血再灌注损伤保护作用的研究

Study on the Protective Effect of Bilobalide on Ischemical Reperfusion Injury in Rats Undergoing Liver Transplantation

目的:观察银杏内酯对大鼠自体原位肝移植缺血再灌注损伤的影响,探讨其对大鼠移植肝缺血再灌注损伤的保护作用。方法:通过银杏内酯在门静脉-左肾静脉搭桥、肝后下腔静脉内置管分流法建立的大鼠自体原位肝移植模型上的应用,采用硝酸酶还原法测定肝脏缺血前和再灌注后5min、30min、2h血清血管活性递质一氧化氮(NO)和血浆内皮素(ET1)的水平变化;测定血清谷丙氨基转移酶(ALT)、谷草氨基转移酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)的酶学差异和肝组织三磷酸腺苷(ATP)及丙二醛(MDA)的含量变化;再灌注2h取肝组织,用甲醛固定制成电镜标本,观察肝细胞、肝小叶超微结构。结果:银杏内酯能提高再灌注后血NO水平,并对ALT、AST、LDH的病理性升高有降低作用,且能改善肝脏缺血再灌注损伤的微循环,减轻肝细胞内超微结构的损害程度。结论:肝移植术前施行门腔分流是预防术后发生肝缺血再灌注损伤的有效措施;NO/ET1平衡可能是影响移植肝脏微循环血流量变化的调节因素。银杏内酯对大鼠肝缺血再灌注损伤有保护作用。

OBJECTIVE： To observe the effect of Bilobalide on ischemical reperfusion injury in orthotopic liver transplan- tation model rats and to discuss its protective effect on ischemical reperfusion injury of rats undergoing liver transplantation. METHODS： The model of orthotopic liver transplantation was established by in rats by setting up the bridge between portal vein and left renal vein and building blood bypass by inlaying of canal in the inferior vena, after modeling, the rats were treated with Bilobalide, then levels of NO （active medium of blood vessel） and ET1 before ischemia and at 10 rain, 30rain and 2h after reperfusion were determined by nitratase reduction method; serum levels of ALT, AST, ALP, LDH enzymology, ATP and MDA in the liver tissues were determined as well. The hepatic tissue sample was taken at 2h and fixed with formalin to be made into specimen for observation of the ultrastructure of liver cells and hepatic lobules under electron microscope. RE- SULTS：After being treated by Bilobalide, serum NO level was elevated and the pathological elevated levels of ALT, AST and LDH were brought down, the microcirculation in ischemical reperfusion injury rats was improved and the extent of damage in the ultrastructure of liver cells was lessened in rats. CONCLUSION： Bypass of portal vein and inferior vena cava prior liver transplantation is helpful for the prevention of ischemical reperfusion injury of liver. The balance of NO/ET1 is possibly a factor influencing the blood flow in the microcirculation of transplanted liver. Bilobalide was proved to be of protective effect on is- chemical reperfusion injury in rats.