小型猪小体积肝移植后血清ET-1和NO水平变化研究  

Changes of serum endothelin-1 and nitric oxide after small-for-size liver transplantation in Bama miniature pigs

作　　者：冷建军[1] 韩本立[1] 董家鸿[1] 李昆[1] 陈利均[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》2005年第6期535-537,共3页Journal of Third Military Medical University

基　　金：国家杰出青年科学基金海外青年合作研究基金资助项目(30228030)~~

摘　　要：目的　探讨小体积肝移植损伤分子学机制。方法　用广西巴马小型猪建立全肝供肝原位肝移植对照组(A 组)、右半肝供肝部分肝移植组(B组)和右中叶联合尾状叶供肝部分肝移植组(C组)不同移植量活体部分肝移植模型,动 态检测血清ET- 1和NO水平。结果　A、B组动物7d生存率为100%,C组仅20%。移植肝复流后各组血清ET -1水平显 著上升,1h即达高峰值,随后逐渐下降,术后第7天基本恢复至基础水平。C组除存活1例在第7天外,各时相点均显著 高于A、B组;C组动物在复流后1h血清NO水平显著升高,达到最高峰值,C组水平显著高于A组,随后迅速下降。比较 血清中ET- 1和NO比值变化趋势,可见C组除1例存活动物在第7天水平外,术后各时相点与A组存在显著差异,而B组 各时相点与A组比较无统计学差异。结论　小体积移植肝损伤机制尚未完全阐明,血清ET- 1、NO水平失衡是导致小体积 移植肝微循环损害的重要因素。Objective To investigate the molecular mechanisms of graft injury in small-for-size liver transplantation. Methods Liver transplantation animal models with different graft volumes were established in 15 Bama miniature pigs, which were divided into Group A with whole liver graft, Group B with right half liver graft, and Group C with right lateral combined with caudate lobe graft. The serum endothelin-1 (ET-1) and nitric oxide (NO) levels before operation, at 1 h after reperfusion, and at day 1, 3, 5 and 7 after operation were measured. Results All animals in groups A and B survived for 7 d after operation (100%). Only one in Group C survived for 7 d (20%). Serum ET-1 and NO levels increased obviously after reperfusion, reached the peak value at 1 h after reperfusion, and then ET-1 decreased fleetly in Group A, slowly in Group C, and mildly in Group B. The serum NO peak level was the highest in Group C at 1 h after reperfusion and thereafter the level dropped rapid. The ratio of ET-1/NO in Group C was significantly higher than that in groups A and B, but the ratios were closed to each other in groups A and B or the basic levels. Conclusion As to small-for-size liver transplantation, the reduction of graft vascular volume is the primary pathogenesis of the graft injury. Although the detailed mechanisms in small-for-size graft injury are unclear, the imbalance of ET-1 and NO may be the important molecular mechanism leading to the graft microcirculation dysfunction.

关 键 词：肝移植 小型猪 内皮素 一氧化氮 

分 类 号：R446.11[医药卫生—诊断学] R657.3[医药卫生—临床医学]