间断低氧预适应对大鼠肝切除术后残余肝脏再生的影响

Effects of intermittent hypoxic preconditioning on the residual liver regeneration after parital hepatectomy in rats

目的 研究间断低氧预适应对大鼠肝切除术后残余肝脏再生的影响。方法 54只SD大鼠用SPSS软件随机分为3组：假手术组（SO组）、肝部分切除组（PH组）和间断低氧预适应组（IHP组）。PH组切除大鼠的左叶和中叶肝脏,约占70％。IHP组大鼠每日在低氧环境下暴露1h,连续进行1周后行肝切除术。于术后第1、3、5天每组随机选取6只SD大鼠处死进行检测。称取肝脏重量,计算肝脏再生度和再生指数。取下腔静脉血用全自动生化分析仪检测血清谷丙转氨酶（ALT）和谷草转氨酶（AST）水平。采用免疫组化方法检测残余肝组织增生细胞核抗原（PCNA）阳性率。结果 IHP组术后第1天和第3天残余肝脏的再生度和再生指数明显高于PH组（P＜0.05）,而术后第5天两组差异无统计学意义。虽然IHP组和PH组大鼠术后血清ALT和AST水平开始下降,但二者均明显高于SO组,且术后第1天IHP组明显低于PH组（P＜0.05）。术后各个时间点IHP组残余肝脏的PCNA阳性细胞比例明显高于SO组和PH组（P＜0.05）。结论 间断低氧预适应能够在一定程度上防止肝切除术后残余肝组织中肝细胞破坏,并且能促进肝脏的早期再生。但其机制需进一步研究。

Objective To investigate the effects of intermittent hypoxic preconditioning on residual liver regeneration after parital hepatectomy in rats.Methods Fifty-four Sprague-Dawley rats were randomly divided into 3 groups （each group contained eighteen animals）：sham operation group （SO group）,parital hepatectomy group （PH group）and intermittent hypoxic preconditioning group （IHP group）.The rats in PH group underwent the left and middle lobectomy of liver（70％ hepatectomy）.The rats in IHP group were exposed to hypoxic environment of 10％ oxygen for 1 h/d.And after a week,the rats underwent parital hepatectomy.Six rats in each group were sacrificed respectively on postoperative day 1,3 and 5 （POD 1,3 and 5）.The resected liver and the regenerated liver were weighed to calculate liver regeneration degree and regeneration index.The values of alaninea minotransferase （ALT） and aspartate aminotransferase （AST） in the inferior vena venous blood were examined by automatic biochemical analyzer.The positive ratio of hepatocellular proliferating cell nuclear antigen （PCNA） in the residual liver was investigated immunohistochemically.Results The degree and index of liver regeneration in IHP group were respectively higher than those in PH group on POD 1 and 3（P ＜0.05）,but there were no statistical differences between the two groups on POD 5.The levels of ALT and AST in PH and IHP group began to decline after surgery,but they remined higher than those in SO group.Moreover,the ALT and AST levels in IHP group were significantly lower than those in PH group on POD 1 （P ＜0.05）.The positive ratios of hepatocellular PCNA were respectively higher than those in SO and PH group on POD 1,3 and 5 （P ＜ 0.05）.Conclusions To some extent,preoperative intermittent hypoxic preconditioning could prevent hepatocellular damage after parital hepatectomy,what is more,it also could promote the remnant liver regeneration.But the mechanism still needs to be studied furter.