大鼠原位肝移植模型建立和受体甲状腺激素水平变化的研究

Research on thyroid hormone protocol after experimental orthotopic liver transplantation

目的 :为研究肝移植术后甲状腺激素水平变化 ,探讨其与肝移植预后的关系。方法:选用Lewis大鼠建立原位肝移植模型 ,对移植前后甲状腺激素水平变化进行序贯检测研究。本实验共进行大鼠原位肝移植91次 ,定向手术成功率92.7 %。分别于手术后1、3、7、14、28d经眶静脉丛采血测量甲状腺相关激素T3、T4、rT3、TSH的血清浓度 ,比较肝移植手术前后甲状腺激素谱的变化。结果 :同系移植肝脏可获得长期存活 (>28d) ,在肝移植后甲状腺激素水平发生变化 ,T3 水平在术后第三天升高 ,随后下降。早期死亡组动物的甲状腺激素水平与长期存活组相比明显不同 ,T3、T4 水平下降 ,而rT3 水平则上升。结论:建立稳定肝移植模型是关键 ,大鼠肝移植术后血清甲状腺激素水平较术前有明显变化 ,提示肝移植手术影响甲状腺激素代谢 ,早期死亡组血清甲状腺激素水平变化与长期存活组比较有明显不同 ,肝移植术后甲状腺激素水平变化的监测 。

Objective: To research the conversion of thyroid hormone profile after liver transplantation and work out the possible relationship between the hormone profile and the prognosis,Methods:To establish an effective method 91 cases of orthrotopic rat liver tramsplantation(ORLT)were performed in lewis rats blood somples were collected at POD1,3,7,14,28the serum level of T3,T4,rT3and TSH perioperativelly were investigaed. Results:It demonstrated that thyroid hormone altered after liver transplantation, serum level of T3 elevated and reached the peak on POD3 and then decline to normal on POD7.There were significant differences between the groups of the dead and survival .The concentrations of the T3 and T4 of the dead are lower than that of survival while the rT3 level are higher. Conclusion:Technique of microsurgery is cardinal to rat liver transplantation, The thyroid hormone level elevated after liver transplantation, The thyroid hormone profile of the dead differed significantly from survival Monitoring of the thyroid hormone profile might provide a valid indicator to prognosis of liver transplantation