乌司他丁对肝脏冷保存损伤的保护作用研究  

Protection against liver injuries induced by low - tempreture preservation with ulinastatin

作　　者：洪勇[1] 古维立[2] 曹杰[2] 夏杰[2] 

机构地区：[1]桂林医学院附属南溪山医院肝胆外科,广西桂林541002 [2]广州医学院附属广州市第一人民医院,广东广州

出　　处：《中国危重病急救医学》2007年第7期398-400,I0001,共4页Chinese Critical Care Medicine

基　　金：广东省医学科研立项课题（A2006506）;广州市医药卫生科技立项课题（2005-YB-006）

摘　　要：目的 探讨乌司他丁对肝脏冷保存是否具有保护作用及其可能的机制。方法 采用大鼠肝脏单纯冷保存离体灌注模型,用UW液中加入乌司他丁冷保存鼠肝（实验组）,同时设单纯UW液保存对照组。收集不同保存时间点（0、12和24h）肝脏灌洗液,检测反映肝细胞功能的丙氨酸转氨酶（ALT）、乳酸脱氢酶（LDH）水平;取肝组织标本,检测反映中性粒细胞聚集性的髓过氧化物酶（MPO）以及反映细胞氧化性损伤的氧自由基代谢产物丙二醛（MDA）、超氧化物歧化酶（SOD）;在光镜和电镜下观察肝组织病理学变化。结果 在12h和24h保存时间点,实验组灌洗液中ALT和LDH以及肝组织中MDA和MPO均明显低于对照组,且ALT、LDH、MDA和MPO水平均随保存时间延长而增高（P均〈0.01）;实验组SOD则明显高于对照组,且随时间延长而降低（P均〈0.01）。实验组肝组织病理学改变明显轻于对照组。结论 ①UW冷保存液对肝脏的冷保存有随时间延长其保护作用逐渐减弱的趋势。②UW液中加入乌司他丁对肝脏冷保存损伤具有保护作用,其机制与乌司他丁抑制中性粒细胞聚集、抗氧化损伤及膜稳定剂作用等有关。Objective To study whether ulinastatin has a protective role in cold preservation of liver and its mechanism. Methods To study the role of ulinastatin in protection of liver after cold preservation, the isolated rat liver with perfused either with cold perfusion fluid or perfused with cold perfusion fluid with ulinastatin. Liver tissue was harvested at 0, 12 and 24 hours after cold perfusion, and morphological changes were examined, alanine aminotransferase （ALT）, lactate dehydrogenase （LDH）, thoperoxidase （MPO）, malondialehyde （MDA） and superoxide dismutase（SOD） contents were also determined. Results ALT, LDH, MPO and MDA contents were significantly lower in ulinastatin group than those in the control group at 12 and 24 hours,and levels of ALT, LDH, MDA and MPO were increased along with prolongation of preservation time （all P〈0.01）, but SOD was higher in ulinastatin group than the control group and it was increased along with the prolongation of time （all P〈0.01）. Compared with ulinastatin group, the control group showed obvious pathological changes. Conclusion Protective effect of UW solution used in clinic weakens gradually as cold preservation time is prolonged. Ulinastatin has protective effect on liver against cold preservation injury, and its effect is better than the simple UW solution. Its mechanism is related to inhibition of anti -oxidation and aggregation neutrophil＇s accumulation effect of ulinastatin.

关 键 词：乌司他丁 肝移植 冷保存损伤 保护作用 

分 类 号：R686[医药卫生—骨科学]