三种肝血流阻断法对大鼠肝脏缺血再灌注后肝细胞凋亡的影响

Effect of three hepatic vascular occlusion on apoptosis of liver cells during ischemia-reperfusion injury in rats

目的探讨三种肝血流阻断法对大鼠肝缺血再灌注损伤后肝细胞凋亡的影响。方法将128只大鼠随机分为假手术组、Pringle法组、半肝阻断组和保留半肝动脉血供的入肝血流阻断组。分别于再灌注后1h、2h、6h和24h检测ALT和AST水平及肝细胞凋亡率,观察肝脏病理学及肝细胞超微结构改变。结果 Pringle法再灌注后各时间点ALT和肝细胞凋亡率显著高于半肝血流阻断组和保留半肝动脉血供的入肝血流阻断组;肝脏病理学包括肝细胞超微结构变化重于半肝血流阻断组和保留半肝动脉血供的入肝血流阻断组;再灌注后72h,Pringle法、半肝血流阻断和保留半肝动脉血供的入肝血流阻断组生存率分别为87.5%(7/8)、100%(8/8)和100%(8/8)。结论保留半肝动脉血供的入肝血流阻断法能够减少缺血再灌注后肝细胞凋亡,减轻肝脏缺血再灌注损伤。

Objective To investigate the effect of three hepatic vascular occlusion maneuvers on the apoptosis of liver cells during ischemia-reperfusion injury in rats.Methods One hundred and twenty-eight Wistar rats were randomly divided into the sham operation group（SO,n=8）,Pringle group（PR,n=40）,hemihepatic vascular occlusion group（HH,n=40）and hepatic blood inflow occlusion without hemihepatic artery control group （WH,n=40）.Each group except for the SO group was further devided into 5 subgroups （n=8）,which were 1h,2h,6h,24h and 72h group,respectively.After 30min of hepatic vascular occlusion with three methods,the liver blood flow was reperfused.The liver cell apoptosis rate,hepatic histopathology and the survival rate at 72 hours after reperfusion were measured.Results After each period of reperfusion,ALT,AST and apoptosis rates were significantly higher in PR group than in HH and WH group,and the pathological and ultrastructural changes of hepatic tissues at 6 hours after reperfusion were significantly worse in PR group than in HH and WH group;Survival rates at 72 hours after reperfusion were 87.5%（7/8）,100%（8/8）and 100%（8/8）,respectively,in PR,HH and WH group.Conclusion Hepatic blood inflow occlusion without hemihepatic artery control can reduce hepatic ischemia-reperfusion injury.