间断性肝门阻断下肝细胞超微结构变化和应激基因的表达研究

Hepatic stress genes expression and ultrastructural feature under intermittent Pringle manoeuvre in hepatectomy patients

目的 研究间断肝门阻断对肝细胞结构及应激基因变化的影响。方法 选择 33例和 14例 (分别作为实验组和对照组 ) ,采用半定量RT PCR方法和电子显微镜技术检测肝叶切除前后应激基因TNF α、IL 6、HSP70A和HSC70的表达状况及细胞超微结构的改变。结果 热休克基因家族HSP70A和HSC70在间断肝门血流阻断组阻断前后的mRNA表达分别为 1 5± 0 2 9,2 0 3± 0 5 3(u =0 92 ,Ρ <0 0 5 ) ;1 6 9± 0 47,1 86± 0 36 (u =1 0 ,Ρ <0 0 5 )。在对照组 ,HSP70A和HSC70切肝前后的表达值分别为 1 39± 0 2 2 ,0 92± 0 3(P >0 0 5 ) ;1 32± 0 19,1 2 8± 0 2 6 (P >0 0 5 )。TNF α和IL 6在两组中无明显差异。电子显微镜下发现阻断组肝细胞及肝窦内皮细胞的超微结构保持正常。结论 间断肝门血流阻断方法能诱导肝组织热休克基因家族高表达 ,这对保持肝细胞间的稳定和正常的超微结构非常重要。

ObjectiveTo evaluate the expression of heat shock genes and acute phase genes and to examine the hepatic ultrastracture under the stress of intermittent Pringle manoeuvre. MethodsRT-PCR was used to detect the expression of HSP70A, HSC70, TNF-α and IL-6,and electronic microscopy examination was taken to document the ultrastructural change in patients with hepatocellular carcinoma, with or without, Pringle manoeuvre, during the operations. ResultsHeat shock gene family-HSP70A and HSC70, which is related to intracellular repair and cell protection, was on higer expression after liver transection in Pringle manoenvre group than that of control group. Normal ultrastructure were also found in liver parenchymal cells and nonparenchymal cells in Pringle manoeuvre group after liver resection. ConclusionIntermittent Pringle manoeuvre induced relatively higher expression of heat shock genes, which are related to intracellular homestasis, and was consistent with the well maintenance of liver ultrastructure.