罂粟碱对大鼠肝热缺血再灌注期微循环影响的活体观察

Observation of the Effect of PAP on the Rat's Hepatic Microcirculation in Thermal Ischemia Reperfusion Injury Period

目的研究大鼠肝脏热缺血再灌注期应用罂粟碱 (PAP)对改善及保护肝微循环的效果 ,并探讨门静脉途径给药的可行性。方法选择Wistar大鼠20只 ,随机分为两组。实验组 :PAP3.18mg/kg,对照组 :NaCl4ml;按misra方法复制肝原位热缺血再灌注模型 ,恢复再灌注后门静脉置管 ,分别给于PAP、NaCl。通过倒置显微镜活体观察两组用药前、后肝中央静脉管径、肝窦开放数及其血流速度的变化情况 ;检测血清SOD、ALT、AST、LDH及肝组织病理检查。结果1、热缺血再灌注期肝中央静脉直径较复制模型前变窄 (P<0.05)、血流速度减慢 (P<0.05) ,肝窦开放数减少 (P<0.01)。2、热缺血再灌注期用药后较用药前肝中央静脉直径增宽 (P<0.05)、血流速度加快 (P<0.01)。肝窦开放数增多 (P<0.05)。3、实验组SOD水平较对照组增高 (P<0.05) ;ALT、AST、LDH水平低于对照组 (P<0.01)。4、光镜检查 :肝窦扩张程度较对照组明显 (P<0.05) ,肝细胞浊肿变性及肝细胞坏死程度轻于对照组 (P<0.05)。结论1、大鼠肝热缺血再灌注期存在有严重的微循环障碍和再灌注损伤 ;2、PAP能有效改善大鼠肝热缺血再灌注期的微循环障碍 ,减轻肝组织再灌注损伤 ;3、活体再灌注期经门静脉途经给药对改善肝微循环效果确切。

Objective To investigate the effect of papaverine(PAP) on improving and protecing the hepatic microcirculation in therma1 ischemia reperfusion injury period(IPI) and porbing into the feasibi1ity of administering medicine by portal vein.Methods Twenty wistar rats were divided into two groups randomly, experimental group(PAP 3.18 mg/kg) and control group(NaCl 4ml); the model of orthotopic liver thermal ischemia reperfusion was duplicaed in misra method and then PAP and NaCl were projected respectively by portal vein catheterization after reperfusion. Converting the microscope to observe the number of dilated sinusoids, the speed of blood flowing and the change of terminal hepatic venules caliber before and after giving PAP and NaCl. After that, the sera levels of SOD?ALT?AST?LDH were measured and pathological examination of its liver was done.Results 1. After duplicating model, the diameter, the blood flowing speed of central hepatic venules, the number of dilated sinusoids hepatic venules were considerably decreased in ischemia reperfusion injury(P<0.05, P<0.05, P<0.01,respectively), 2, After giving PAP, the diameter, the blood fiowing speed of central hepatic venules, the number of dilated sinusoids hepatic venules were significantly increased(P<0.05,P<0.01,P<0.05,respectively).3,The level of SOD in sera in experimental group was higher than that in control group(P<0.05),the level of ALT, AST and LDH in experimental group was lower than that in control group(P<0.01); 4.The expansion of liver sinusitis was faster(P<0.05) and hepatocelluar cloudy swelling degeneration and necrosis were less severe (P<0.05) in experimental group than those in control group. Conclusion 1. There are severe microcirculatory malfunction and ischemia reperfusion injury in hepatic thermal ischemia reperfusion.2. PAP can protect microcirculation and improve reperfusion injury effectively.3.Administering medicine by portal vein has distinct effect on improving hepatic microcirculation in vivo ischemia reperfusion period.