窒息对大鼠肝细胞超微结构和元素分布的影响  

Ultrastructural and elemental effects of asphyxia on liver cells in rats

作　　者：朱会耕[1] 叶若兰[1] 方勇[1] 

机构地区：[1]复旦大学附属华山医院危重病科,上海200040

出　　处：《复旦学报（医学版）》2008年第3期384-388,共5页Fudan University Journal of Medical Sciences

摘　　要：目的通过研究窒息动物肝细胞超微结构及其元素含量的变化,探讨窒息引起肝脏损害的发病机制,为临床抢救窒息患者时对保肝措施予以关注提供科学依据。方法SD大鼠经腹腔麻醉后,经气管插管由人工呼吸机维持通气,窒息组在关闭人工呼吸机使呼吸停止3、6、9、12、15min后取肝脏。窒息-复氧组在呼吸停止后3、6、9、12、15min后重新开启呼吸机120min,再取肝脏。样本经处理后进行透射电镜观察和元素显微分析。结果大鼠窒息3min时肝细胞已出现滑面内质网囊管扩张和线粒体基质变深。窒息6min时线粒体肿胀、粗面内质网脱颗粒。窒息12min时线粒体破坏,核异染色质聚集成团块状。窒息15min时可以出现部分肝细胞坏死。经过120min复氧,仅窒息6min时线粒体肿胀程度减轻,其余各组均未见改善。窒息后,肝细胞及其线粒体Na、K元素含量明显降低,而Cl、Ca元素含量则显著升高;窒息后经过120min复氧,除Ca含量有所恢复外,Na、K、Cl的变化没有改善。结论肝脏在窒息早期即发生细胞结构损伤,窒息后虽然经过及时复氧,但细胞结构损伤改善有限,窒息引起肝细胞Na、Cl、K、Ca浓度的持续变化可能是造成肝脏损伤的原因之一。Objective To investigate the mechanism of liver injury through studying the change of ultrastructure and electrolytes of rat liver during asphyxia. Methods After peritoneal anesthesia and tracheal intubation, we switched off mechanical ventilation for 3, 6, 9, 12 and 15 min in each group re- spectively and took out the liver. The rats of asphyxiaresuscitation group were reventilated for 120 min after breath stopping before taking the transmission electron microscope and ions liver. All the specimens were analyzed for ultrastructure on through quantitative electron probe X-ray microanalysis.Results Vesicula of smooth endoplasmic reticulum dilated and mitochondrial matrix darkened after asphyxia for 3 min. Mitochondria swelled and rough endoplasmic reticulum degranuled after asphyxia for 6 min. Mitochondria degenerated and heterochromatin aggregated after asphyxia for 12 min. Partial liver cell necrosis appeared after asphyxia for 15 min. After resuscitation for 120 min, no improvements was observed except mitochondria swelling ameliorated in the group asphyxia for 6 min. Concentration of Na and K decreased notably while Ca and Cl increased on asphyxia. After resuscitation for 120 rain, no improvement was seen in the concentration of Na, K, and Cl except Ca. Conclusions Liver cell injury happens in the early stage of asphyxia. The improvement of cell injury is limited even after prompt resuscitation. The continuous change of concentration of Na, Cl, K and Ca may related to liver injury caused by asphyxia.

关 键 词：肝 窒息 超微结构 元素分析 

分 类 号：R459.7[医药卫生—急诊医学]