肝脏缺血预处理的研究进展

Research Advancement of Hepatic Ischemic Preconditioning

目的总结肝脏缺血预处理(ischemic preconditioning,IPC)的保护机理及其在肝切除、肝移植中的临床研究进展。方法复习近年来肝脏IPC的基础和临床研究的文献。结果实验研究表明,IPC主要通过维持和改善肝脏能量代谢、改善微循环障碍、减轻脂质过氧化和氧自由基的产生、抑制炎性细胞的激活和细胞因子的释放、抑制细胞凋亡、诱导内源性保护物质的释放等途径保护肝脏缺血-再灌注(ischemia-reperfusion,IR)损伤;目前多数临床研究肯定了肝脏IPC的保护作用,但也有报道显示IPC不能保护肝脏IR损伤。结论肝脏IPC能够减轻肝脏IR损伤,但其在肝切除及其肝移植中的临床应用价值有待进一步的研究。

Objective To summarize recent researches on mechanism of the hepatic ischemic preconditioning （IPC） and its clinical applications on hepatectomy and liver transplantation. Methods Relevant references about basic and clinical researches of hepatic IPC were collected and reviewed. Results Recent experimental researches indicated that IPC could relieve hepatic ischemia-reperfusion injury （IRI） by remaining and improving energy metabolism of liver, regulating microcirculation disorder, decreasing the production of lipid peroxidation and oxyradical. It could also inhibit the activation of inflammatory cells and the release of cytokine, suppress cell apoptosis and induce the release of endogenous protective substance. Till now, most of the clinical researches had confirmed the protective function of hepatic IPC, but there were still some references with opposite opinions. Conclusion Hepatic IPC could relieve liver IRI, but its clinical application value on hepatectomy and liver transplantation still need more researches to prove.