肝上下腔静脉控制性失血减轻大鼠肝脏缺血再灌注损伤  

Suprahepatic vena cava manipulative bleeding alleviates liver ischemia-reperfusion injury

作　　者：贾长库[1] 王文擘[1] 朱有法[2] 郑树森[1] 

机构地区：[1]浙江大学医学院附属第一医院肝胆外科,卫生部多器官联合移植重点实验室,浙江杭州310003 [2]浙江大学医学院病理教研室,浙江杭州310003

出　　处：《中国病理生理杂志》2008年第1期112-115,共4页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.30671991);浙江省自然科学基金资助项目(No.Y205204)

摘　　要：目的:确定肝脏缺血再灌注(HIR)时肝上下腔静脉(SH-VC)血中氧自由基(ROS)产生的时相及峰值,探讨SH-VC控制性失血处理对HIR损伤的影响。方法:用大鼠HIR损伤模型,分别测定再灌注后0min、5min、10min、30min、1h、2h、6h模型组与假手术组SH-VC及肝下下腔静脉(IH-VC)血中MDA的含量;在再灌注后的10min分别在SH-VC及IH-VC进行放血处理,观察其对HIR损伤的影响。结果:HIR时SH-VC血中MDA的含量随时间的延长逐渐升高,并在再灌注后10min达到高峰,并且再灌注后0、5和10min3个时段,SH-VC内MDA的含量明显高于IH-VC内的含量;2%SH-VC放血输血处理组血清MDA的含量明显低于未处理组,处理后6h血清ALT和AST的含量都显著低于未处理组,并且生存率明显提高达7d左右。结论:本研究首次发现HIR时SH-VC血中的ROS含量随着再灌注时间的延长而增高,并在10min时达高峰。在10min高峰期进行20%SH-VC放血输血处理,明显减轻HIR损伤。AIM： To determine the time course and peak production of reactive oxygen species （ROS） in suprahepatic vena cava （SH -VC） after hepatic ischemia -reperfusion（HIR） and to study the effects of posthepatic manipulative bleeding on HIR injury in rat model. METHODS： Rat 35 min total hepatic ischemia model was used in this study. Blood was taken, from SH -VC and infrahepatic vena cava （IH -VC）, for MDA detection at 0 min, 5 min, 10 min, 30 min, 1 h, 2 h and 6 h after reperfusion respectively. Then the experimental rats were treated with posthepatic manipulative bleeding or IH - VC manipulative bleeding at 10 min after reperfusion. RESULTS： MDA concentration in SH - VC elevated obviously with time and peaked at 10 min after reperfusion. Two percent of body weight posthepatic manipulative bleeding with blood transfusion at 10 min after reperfusion significantly decreased circulating MDA,ALT and AST levels and improved survival rate. CONCLUSION： ROS concentration in SH - VC elevates obviously after reperfusion. Two percent of body weight suprahepatic vena cava manipulative bleeding with blood transfusion at 10 min after reperfusion can afford significant protection against warm HIR injury.

关 键 词：肝 再灌注损伤 活性氧 腔静脉 

分 类 号：R675.3[医药卫生—外科学]