前列腺素E1在体外肝脏灌流中对无心跳供肝保护作用的实验  

The protective effect of Prostaglandin E_1 on NHBD livers with extracorporeal liver perfusion system

作　　者：龚瑾[1] 劳学军[1] 曹明溶[1] 王西墨[2] 龙刚[2] 陈实[3] 

机构地区：[1]暨南大学附属第一医院外科,广东广州510630 [2]天津市人民医院外科,天津300120 [3]华中科技大学同济医学院附属同济医院器官移植研究所,湖北武汉430030

出　　处：《暨南大学学报（自然科学与医学版）》2008年第2期168-172,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家十五“863”基金资助项目(2001AA216071);广东省卫生厅资助项目(A2006345)

摘　　要：目的:探讨无心跳供肝缺血再灌注损伤时发生微循环障碍的机制,以及前列腺素E1在体外肝脏灌流中对无心跳供肝的保护作用。方法:实验根据是否在体外肝脏灌流(extracorporeal liver perfusion,ECLP)系统的灌流液中加入前列腺素E1(PGE1)随机分为2组:A组(对照组)和B组(实验组)。观察灌流后6 h 3个时间点供肝的胆汁分泌量、门静脉和肝动脉的压力、耗氧率的变化,以及灌流液中丙氨酸氨基转移酶(ALT)、乳酸脱氢酶(LDH)、内皮素-1(ET-1)和肿瘤坏死因子-α(TNF-α)水平和灌流后的常规病理和超微病理变化。结果:B组肝脏再灌流后在1h时间点的胆汁分泌量、门静脉和肝动脉的压力和耗氧率和A组差异没有显著性,但随着灌流时间的延长,B组肝脏的胆汁分泌量、门静脉和肝动脉的压力和耗氧率和A组差异均有差异性(P<0.05或P<0.01);灌流液中ET-1和TNF-α水平在各个时间点两组差异均有显著性(P<0.05或P<0.01);常规病理和超微病理检查显示B组病变较A组轻。结论:在无心跳供肝的缺血再灌注损伤中ET-1和TNF-α起了非常重要的作用,在ECLP系统灌流液中使用PGE1灌流无心跳供肝可以抑制ET-1和TNF-α的合成和分泌,改善肝脏的微循环障碍和降低肝功能的损伤。Aim：To study the protective effect of prostaglandin E1 on noneart-beating donor livers with extracorporeal liver perfusion system. Methods： Livers were harvested from healthy pigs, according to using or not using PGE1 in the blood for perfusion. Those were randomly divided into to 2 groups： Group A （n =4）, during the perfusion, no PGE1 was added; GroupB （n =4）, during the perfusion, PGE1 was added the blood for perfusion. The data of bile production, hemodynamic parameters and the markers of hepatocyte and reperfusion injury of extracorporeal livers in each group were tested. The histo-logical examination of liver tissues from each group were performed at the end of reperfusion. Results： The data of bile production, hemodynamic parameters and the markers of hepatocyte and reperfusion injury of livers in group B were statistically different from those of livers in group A （ P 〈 0. 05 or P 〈 0. 01 ）, which were supported by histological examination. Conclusion： PGE1 treatment during the non-heartbeating livers extracorporeal perfusion can improve the microcirculation of liver and attenuate injury.

关 键 词：前列腺素E1 体外肝脏灌流 无心跳 

分 类 号：R657.3[医药卫生—外科学]