蓝光照射联合血浆灌流治疗犬急性肝衰竭的实验研究

Blue light irradiation combined with plasma perfusion for acute liver failure in dogs

目的建立犬急性肝衰竭模型，在传统血浆灌流基础上，对血浆预先进行蓝光照射后回输，验证该方法是否提高血浆胆红素下降幅度。方法选用健康雄性Beagle犬12只，通过外科手术诱导急性肝衰竭。急性肝衰竭犬随机分为两组：A组（n=6）予以血浆灌流治疗，B组（n=6）在血浆灌流前将血浆照射15min蓝光。在灌流前和灌流后的第24小时采血一次，通过观察治疗前后血浆谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（Tbil）、直接胆红素（Dbil）、总蛋白（TB）、球蛋白（GLB）、白蛋白（ALB）的变化评估治疗效果。结果与术前比较，术后14dA组和B组ALT、AST、Tbil、Dbil均显著性上升，A组与B组比较差异无统计学意义，TB、GLB和ALB则变化不明显；A组和B组在治疗后ALT（A：119．3±69．8；B：112．9±102．2）、AST（A：103．5±20．9；B：118．0±32．6）均有不同程度下降，但治疗后两组比较差异无统计学意义（P〈0．05）；A组和B组Tbil、Dbil在治疗后均有下降，但B组Tbil（22．1±7．8）、Dbil（11．4±3．1）显著低于A组Tbil（95．6±21．5）、Dbil（48．9±12．3），差异有统计学意义（P〈0．05）；A组和B组在治疗后血浆总蛋白（A：36．8±4．6；B：39．9±6．9），球蛋白（A：23．5±2．9；B：23．0±2．6）和白蛋白（A：25．0±4．QB：28．8±3．0）均有下降，但B组治疗后与A组治疗后血浆蛋白差异无统计学意义（P〈0．05）。结论蓝光照射联合血浆灌流比传统的血浆灌流更能提高单次治疗的血浆胆红素下降幅度。

Objective To establish canine models of acute liver failure and explore if plasma perfusion after blue light irradiation for acute liver failure in dogs can markedly decrease their blood bilirubin. Methods Liver failure was surgically induced in 12 healthy male beagle dogs. The dogs with acute liver failure were divided into group A （n=6）, treated with plasma perfusion, and group B （n=6）, treated with blue light irradiation combined with plasma perfusion. Treatment effects were evaluated by testing and comparing the plasma alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （Tbil）, direct bilirubin （Dbil）, total protein （TB）, globulin （GLB）, and albumin （ALB） before and after the treatment. Results ALT, AST, Tbil, and Dbil significantly increased but TB, GLB, and ALB had no obvious change in both groups 14 days after the treatment, without statistical differences between the 2 groups （P 〉 0.05）. ALT （A： 119.3±69.8, B： 112.9±102.2） and AST （A： 103.5±20.9, B： 118.0±32.6） decreased in both groups after treatment, with no statistical differences between the 2 groups （P〉 0.05）. After treatment, Tbil and Dbil significantly decreased in both groups （P 〈 0.05 ）. Tbil and Dbil （22.1±7.8, 11.4± 3.1） were significantly lower in group B than in group A （95.6±21.5, 48.9 ±12.3b）. TB （A： 36.8 ±4.6, B： 39.9± 6.9）, GLB （A：23.5 ±2.9, B：23.0± 2.6）, and ALB（A： 25.0±4.0, B： 28.8±3.0） significantly decreased in both groups, without statistical differences between the 2 groups （P 〉 0.05）. Conclusion Blue light irradiation combined with plasma perfusion is more effective in decreasing blood bilirubin than conventional plasma perfusion.