缺血预处理对大鼠移植肝脏微循环的保护作用

Protective effect of ischemic preconditioning on microcirculation of rat liver graft

目的 探讨早期再灌注损伤中缺血预处理 (IP)对大鼠移植肝脏微循环的保护作用。方法 采用SD大鼠原位肝移植动物模型 ,供肝冷保存时间 10 0min ,无肝期 2 5min。 3 2只SD大鼠随机平均分成两组 ,每组 16只。对照组 :获取供肝前仅以肝素生理盐水经门静脉灌注 ;IP组 :获取供肝前阻断肝门血供 10min ,再灌注 10min ,然后再以肝素生理盐水经门静脉灌注。移植肝脏再灌注 2h后取血及肝脏检测。结果 IP组的肝脏抗氧化酶活力明显高于对照组 (P <0 .0 1) ,血清丙氨酸转氨酶(ALT)、门冬氨酸转氨酶 (AST)、乳酸脱氢酶 (LDH)及肝组织中的过氧化产物丙二醛 (MDA)含量均明显低于对照组 (P <0 .0 0 1) ;肝组织损伤以窦状内皮细胞为主 ,并且是以凋亡的方式发生死亡 ,IP组窦状内皮细胞损伤明显轻于对照组 (P <0 .0 0 1)。

Objective To investigate the protective effect of ischemic preconditioning on microcirculation of rat liver graft during the early phase of reperfusion injury. Methods Male Sprague Dawley (SD) rats were used as donors and recipients of orthotopic liver transplantation. The period of cold preservation and anhepatic phase were 100 min and 25?min respectively. 32 rats were randomly divided into 2 groups (n=16 in each). In the control group, donor livers were flushed through the portal veins with physiological saline solution containing heparin only before harvested; In the IP group, before donor livers were harvested, the portal veins and hepatic arteries of them were interrupted for 10?min, and reflow was initiated for another 10?min, then did as control group. The sample of blood and hepatic tissue of both groups were taken after 2?h of reperfusing liver graft. Results Activity of anti-oxidase in hepatic tissue was higher in IP group than in control group (P<? 0.01), while serum ALT, AST, LDH and superoxide in hepatic tissue were lower in IP group than in control group (P<? 0.001). Sinusoidal endothelial cells were the principal target of reperfusion injury and their deaths were caused by apoptosis. Sinusoidal endothelial cells of IP group showed less injury than those in control group (P<? 0.001). Conclusion IP could protect the microcirculation of rat liver graft from injury during the early phase of reperfusion.