摘要
目的探讨治疗性高碳酸血症对大鼠移植肝脏缺血再灌注损伤的影响。方法清洁级雄性Wistar.大鼠32只,6周龄,体重220~280g,采用完全随机设计的方法两两配对实施肝脏原位移植16只。采用随机数字表法,将受体鼠随机分为2组(n=8):肝移植组(LT组)和治疗性高碳酸血症组(TH组)。LT组再灌注即刻吸入50%02—50%N1混合气体2h;TH组再灌注即刻吸入O2-M-CO2混合气体1h,调节气体浓度和呼吸频率,维持FiO250%、PaCO280~100mrnHg,而后继续吸人50%02—50%N1混合气体1h。再灌注期间记录MAP、PaO2和PaCO2。再灌注2h时,取动脉血样,测定血清ALT、AST、TNF-α、IL-1和IL-6的水平;取肝组织,测定NF-KB活性,计算凋亡指数,观察肝组织病理学结果。结果与LT组比较,TH组血清ALT、AST、TNF-α、IL-1和IL-6水平、肝组织NF-κB活性和凋亡指数降低,MAP、PaO1和PaCO2升高(P〈0.05)。TH组肝组织病理学损伤较LT组减轻。结论治疗性高碳酸血症可减轻大鼠移植肝脏缺血再灌注损伤,机制与抑制炎性反应和细胞凋亡有关。
Objective To investigate the effect of therapeutic hypercapnia on hepatic ischemia-reperfusion (I/R) injury in rat liver transplantation. Methods Male specific pathogen-free adult Wistar rats aged 6 weeks weighing 220-280 g were used in this study. Sixteen rats in which liver transplantation was successfully performed were randomly divided into 2 groups (n = 8 each) : liver transplantation group (group LT) and therapeutic hyper capnia group (group TH). In group TH, PaCO2 was maintained at 80-100 mm Hg by inhalation of CO2 for 1 h at the begining of reperfusion. MAP, PaO2 and PaCO2 was recorded during reperfusion. Blood samples were obtained at 2 h of reperfusion for determination of serum ALT, AST, TNF-α, IL-1 and IL-6 levels, and then the rats were sacrificed and transplanted liver was immediately removed for determination of NF-κB activity and apoptosis and mi- croscopic examination. The apoptotic index was calculated.Results MAP, PaO2 and PaCO2 were higher, and se- rum ALT, AST, TNF-α, IL-1 and IL-6 levels, NF-κB activity and apoptotic index lower in group TH than in group LT ( P 〈 0.05). The histopathologic damage was ameliorated in group TH as compared with group LT. Conclusion Therapeutic hypercapnia can attenuate hepatic I/R injury in rat liver transplantation by inhibiting inflammatory response and apoptosis.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2011年第11期1366-1369,共4页
Chinese Journal of Anesthesiology
基金
黑龙江省教育厅科学技术研究项目(1151G028)
关键词
高碳酸血
肝移植
再灌注损伤
Hypercapnia
Liver transplantation
Reperfusion injury