大鼠原位肝脏低温灌注和复流模型的建立及意义

Development and implication of a rat model of liver hypo thermic irrigation and reperfusion in situ

目的 建立一种大鼠肝脏原位低温灌注再复流模型 ,用于离体及活体供肝肝切除术的研究。方法 大鼠 78只 ,分成 4组 ,A、B组分别用乳酸林格氏液和自制灌注液灌注 ,C组仅行全肝血流阻断 ,D组作正常对照。脾静脉和右肾上腺静脉分别作为灌注液流入和流出道 ,行在体原位低温灌注 ,观察再复流后对肝细胞和肝窦内皮细胞的影响。结果 C组再复流 2h和 6h血清透明质酸浓度为 ( 2 5 0 .0± 2 4.1) μg/L、( 2 90 .4± 37.0 ) μg/L ,分别高于A组 ( 14 2 .9± 30 .1) μg/L、( 2 0 0 .0± 17.5 ) μg/L ,差异均有非常显著性 ( P <0 .0 1) ;B组浓度为 ( 63.3± 16.2 ) μg/L、( 62 .1±14 .6) μg/L ,与A组相比浓度更低 ( P <0 .0 1)。结论 该模型方法简单 ,易成功 ,可用于离体和活体供肝肝切除防止肝脏损伤的研究。

Objective To develop a model of liver hy pothermic irrigation and reperfusion in situ in Sprague Dawley rat for experimen tal research in ex situ liver surgery and in procurement of living-related live r graft. Methods Seventy-eight male Sprague Dawley rats (250～3 00 g) were randomly divided into four groups: ischemic-reperfusion (I-R) group (group D, n=24), lactate Ringer's group (group A,n=24),self-design ed solution group(group B,n=24) and non-ischemic control (group C,n=6). Th e splenic vein and the right adrenal vein were utilized as the afferent and the efferent channel in hypothermic irrigation in situ. The morphological changes th at occurred in livers after 2 and 6h reperfusion were observed under light a nd electron microscopy. The damage to the sinusoidal endothelium was estimated b y measuring circulating hyaluronic acid (HA).Results The HA levels in the plasma after 2 and 6h repe rfusion in the group C were(250.0±24.1)μg/L,(290.4±37.0)μg/L respect ively. The HA values in the group A [(142.9±30.1)μg/L,P<0.01],[(20 0.0±17.5)μg/L,P<0.01]and in group B [(63.3±16.2)μg/L,P<0.01 ],[(62.1±14.6)μg/L,P<0.01]were decreased as compared with group C, respectively. In the group B HA level was statistically lower than in the group A (P<0.01). The operative procedure was simple without any stitch on th e ma in vein around the liver. Total blood loss was less than 0.5 ml. The damage to h epatic and sinusoidal endothelial cells was reduced by the hypothermic irrigatio n with self-designed solution.Conclusion This model can accurately reflect pathophysio logical changes of procudure in ex situ liver surgery and in procurement of livi ng-related liver graft.