己酮可可碱对小型猪移植肝胆管缺血再灌流损伤保护作用的实验研究  

Experimental study of the protective effect of PTX on bile duct in grafts against IR injury in the animal model of OLTx in miniature swines

作　　者：郑树国[1] 董家鸿[1] 李昆[1] 

机构地区：[1]第三军医大学西南医院全军肝胆外科研究所,重庆400038

出　　处：《第三军医大学学报》2004年第24期2227-2230,共4页Journal of Third Military Medical University

基　　金：全军医学科学技术研究"十五"计划基金重点课题 ( 0 1Z0 77) ;重庆市自然基金重点课题 (CSTC 2 0 0 4BA50 13)~~

摘　　要：目的　探讨己酮可可碱 (pentoxifylline ,PTX)对小型猪移植肝胆管缺血再灌流 (ischemiareperfusion ,IR)损伤的保护效应及可能机制。方法　在小型猪同种异体原位肝移植模型上观察保存液中加入PTX ,并经肝动脉途径给药对移植肝胆管组织微循环血流量、ATP酶活力、上皮细胞凋亡及病理形态学等的影响。结果　IR +PTX组动物胆管坏死发生率较IR、IR +NS组显著降低 ,且无动物死亡 ;与IR、IR +NS两组比较 ,IR +PTX组术后各时相点GGT、ALP显著降低 ,术中移植肝胆管组织微循环血流量、Na+ K+ ATP酶活力、Ca2 + ATP酶活力显著增加 ,而凋亡细胞数及病理形态学评分均显著降低。结论　PTX对移植肝胆管IR损伤具有多环节拮抗作用 ,其可能机制是改善组织微循环、抑制胆管细胞凋亡及维持胆管细胞ATP酶活力。Objective To investigate the protective effect of pentoxifylline (PTX) on bile duct in grafts against ischemia-reperfusion (IR) injury and its potential mechanisms in the animal model of OLTx in miniature swines. Methods After PTX was added to the preservation solution and administrated through hepatic artery, changes of blood flow, activity of ATPase, apoptosis of epithelial cells, and pathomorphology of the bile duct were investigated in the animal model of OLTx in miniature swines. The animals were divided into IR, IR+NS, and IR + PTX groups. Results The results showed that the incidence of biliary necrosis was significantly lower in IR+PTX group than that in IR and IR +NS groups. When compared with those in IR and IR +NS groups, GGT and ALP levels, numbers of apoptosis cells, and scores of pathomorphology were significantly decreased in IR+PTX group, while blood flow, activity of Na +-K +ATPase, Ca 2+ -ATPase of bile duct in grafts were significantly elevated. Conclusion These results suggest that PTX has multiple antagonistic effects against IR injuries of the bile duct. The effects of PTX on bile duct of grafts against IR injuries are possibly correlated with the improvement of the microcirculation, preservation of the ATPase activity of the bile duct, and suppression of the apoptosis of the bile duct cells.

关 键 词：己酮可可碱 缺血再灌流损伤 肝移植 胆道并发症 小型猪 

分 类 号：R619.9[医药卫生—外科学] R657.3[医药卫生—临床医学]