入肝血流阻断对阻塞性黄疸大鼠肝脏能量代谢的影响

THE EFFECT OF HEPATIC INFLOW OCCLUSION ON HEPATIC ENERGY METABOLISM IN CHOLESTATIC RATS

目的 探讨阻塞性黄疸大鼠肝脏缺血后能量代谢变化的病理特征及其与动物耐受性的关系。方法 大鼠胆管结扎后 1周 ,在门静脉转流下阻断入肝血流不同时程后观察动物存活率、肝细胞线粒体呼吸活性、肝组织ATP含量及动脉血酮体比值。结果 阻断入肝血流 30、6 0及 90分钟后 10天动物存活率分别为 10 0 %、10 0 %及 40 % ;缺血后肝脏能量代谢功能明显受损 ,在再灌注后 2 4小时 ,阻断入肝血流 30及 6 0分钟两组动物肝脏能量代谢功能已有明显恢复 ,而阻断入肝血流 90分钟组肝脏能量代谢功能仍维持在显著低水平。结论 胆道梗阻后 1周 ,大鼠门静脉转流下入肝血流阻断 6 0分钟以内肝脏能量代谢功能损害可逆 ,动物能安全耐受 ;而阻断入肝血流 90分钟引起肝脏能量代谢功能不可逆性损害 ,动物难以安全耐受。

Objective\ To investigate the pathological characteristics of hepatic energy metabolism changes following hepatic inflow occlusion and the tolerant limit to ischemia in cholestatic rats.Methods\ On the day 7 after rats biliary obstruction, the survival rate, hepatic mitochondrial respiratory function, content of ATP, and the ketone body ratio in arterial blood were investigated following the different duration of hepatic ischemia and reperfusion with portal blood bypass.Results\ The survival rate on postoperative day 10 was 100%, 100% and 40% subjected to 30, 60 and 90min of hepatic vascular occlusion. The hepatic energy metabolic function was decreased markedly following ischemia, and was increased markedly on 24 hours following reperfusion subjected to 30, 60min of hepatic vascular occlusion, but it had less increase with 90min of hepatic vascular occlusion.Conclusion\ The hepatic energy metabolic function injury is reversible in cholestatic rats, and the rats can tolerate hepatic inflow occlusion within 60min, but the hepatic energy metabolic function injury is irreversible after 90min of hepatic occlusion.