门静脉转流下缺血对阻塞性黄疸大鼠肝脏能量代谢的影响

Effect of hepatic inflow occlusion on hepatic energy metabolism in rats with obstructive jaundice

目的 探讨在门静脉转流下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 3 0、60及 90min后 10d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 ,在再灌流后 2 4h ,阻断入肝血流 3 0及 60min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 90min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 60min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 90min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 study the pathological chracteristics of hepatic energy metabolism changes following hepatic inflow occlusion and the tolerant limit to ischemia in rats with obstructive jaundice. Methods On day 7 after biliary obstruction, rat survival rate, hepatocytic mitochondrial respiratory function and ATP content, ketone body ratio in arterial blood were investigated in different duration of hepatic ischemia and reperfusion with portal blood bypass. Results The survival rate on postoperative day 10 was 100, 100 and 40 percent when subjected to 30, 60 and 90 min of hepatic vascular occlusion. The hepatic energy metabolic function decreased markedly after ischemia, and increased evidently in 24 h postreperfusion subjected to 30, 60 min of hepatic vascular occlusion, but had less reduction in the rats with 90 min of hepatic vascular occlusion. Conclusion Hepatic energy metabolic function injury was reversible in cholestatic rats with hepatic inflow occlusion within 60 min, but irreversible for those with 90 min of hepatic occlusion.