肠缺血预处理对大鼠肝脏缺血再灌注损伤的保护作用

Intestinal ischemic preconditioning reduces hepatic ischemia-reperfusion injury in rats

目的:研究大鼠的肠缺血预处理对肝脏缺血再灌注损伤(HIRI)的远端保护作用及其机制。方法:30只大鼠随机分为3组,假手术组(Sham组)仅做肝门分离;缺血再灌注组(IR组)采用肝门阻断法(Pringle’s法)缺血30min,再灌注120min,建立缺血再灌注模型;远端预处理组(RIPC组)阻断肠系膜上动脉10min,再灌注10min,然后同IR组。分别取门静脉血清测肝酶(ALT、AST)、内毒素;取肝、肠组织分别作病理学检查、MPO活性测定;取肝组织作免疫组化TNF-α和细胞间黏附分子-1(ICAM-1)测定。结果:RIPC组较IR组:①血清ALT、AST、内毒素减少(P<0.05);②肝和肠组织损伤病理评分、MPO活性降低(P<0.05);③肝组织内TNF-α和ICAM-1表达减少。结论:对大鼠肠的缺血预处理可以发挥远端预处理作用,减轻肝脏的缺血再灌注损伤,可能是通过减少肝脏前炎性因子的表达,减少中性粒细胞的黏附聚集而发挥作用。

Objective：To investigate the effect and mechanism of the intestinal ischemic preconditioning on hepatic ischemia-reperfusion injury in rats. Methods：Thirty SD rats were divided into three groups randomly：sham-operated group（Sham group）, ischemia- reperfusion group（IR group：produced by total inflow occlusion for 30 rain）, and remote ischemic preconditioning group （RIPC group： induced with superior mesenteric artery occlusion before HIRI by 10 rain isehemia and 10 rain reperfusion）. Markers of liver and intesine injury and TNF-α,ICAM-1 in liver were measured after reperfusion for 120 rain. Results：IR group was associated with increased serum aminotransferases （ALT,AST）, MPO activity endotoxin and the pathological injury scores. Meanwhile,in liver tissue TNF-α and ICAM-1 expression were high when IR only. There was significant improvement in these variables in RIPC group. Conclusion： RIPC of the intestine reduced HIRI which may depend on the decrease of pro-inflammatory and activity of neutrophils.