肝硬变大鼠门静脉转流下耐受入肝血流阻断的安全时限

The tolerance limit of rats with liver cirrhosis to hepatic inflow occulusion with portal vein blood bypass

目的 探讨在门静脉转流条件下肝硬变大鼠耐受入肝血流阻断的安全时限。方法 观测门静脉转流与非门静脉转流条件下阻断入肝血流不同时程后动物存活率及肝脏能量代谢的变化 ,包括肝细胞线粒体呼吸控制率 (RCR)、肝组织三磷酸腺苷 (ATP)含量、动脉血酮体比值 (AKBR)。结果术后两周存活率 :肝硬变大鼠PBB 30min组和PBB 4 5min组为 10 0 % ,PTC 30min组、PBB 6 0min组、PBB 75min组及PBB 90min组分别为 73.3%、75 %、4 6 .7%及 2 6 .7%。正常大鼠PTC 30min组为4 0 %。肝脏能量代谢 :缺血后肝组织ATP、RCR及AKBR均明显下降 (P <0 .0 5 )。再灌注后上述指标逐惭恢复 ,但随缺血时间延长 ,升高幅度明显降低 ,甚至难以恢复。结论 肝硬变大鼠常温下耐受入肝血流阻断的安全时限是 4 5min。

Objective To study the effect of portal vein blood bypass(PBB) on the tolerance limit of rats with liver cirrhosis to hepatic inflow occlusion(HIO). Methods Animal survival rate and hepatic energy metabolism were observed following different period of HIO with or without PBB, including repiratory control ratio(RCR), ATP and arterial blood ketone body ratio(AKBR). Results (1) Survival rate of rats with liver cirrhosis within 2 weeks was 100%, 100%, 75%, 46.7% and 26.7% respectively after under going 30, 45, 60, 75 and 90 minutes HIO with PBB. The survival rate of rats with liver cirrhosis and normal rats with 30 minutes of portal trial clamp(PTC) without PBB was 73.3% and 40% respectively. (2) ATP, RCR and AKBR were all significantly decreased after ischemia(P<0.05) and were elevated after reperfusion, but the scale descended obviously with the prolongation of ischemia. Conclusions 45 minute is the tolerance limit of rats with liver cirrhosis to normothermic HIO with PBB.