大鼠部分肝缺血再灌注损伤后切除对肝再生的影响  

Effect of ischemia reperfusion injury before partial hepatectomy on liver regeneration in rats

作　　者：张斌[1] 桂亮[1] 李相成[1] 沈健[1] 唐劲草[1] 许永华[1] 

机构地区：[1]南京医科大学第一附属医院肝脏移植中心,210029

出　　处：《中华实验外科杂志》2011年第7期1127-1129,F0004,共4页Chinese Journal of Experimental Surgery

基　　金：江苏省“科教兴卫工程”医学重点人才基金资助项目[2007]200

摘　　要：目的观察大鼠部分肝缺血再灌注损伤后切除对残肝再生的影响。方法将75只健康雄性SD大鼠随机分为5组：肝脏左叶和中叶（约占全肝70％）切除组（Control组）、肝脏左叶和中叶缺血10min再灌注30min后切除组（110R30组）、类推得到160R30组、190R30组、190R60组。术后6、12、24h等时间点，测定再生肝重量（RLW）；自动生化分析仪检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）含量；酶联免疫吸附试验（ELISA）检测血清肿瘤坏死因子（TNF）-α含量；通过免疫组织化学法检测残肝增殖细胞核抗原（Ki-67）表达。结果术后12h，I60R30、I90R30和I90R60组RLW值分别为（1．80±0．03）％、（1．82±0．10）％、（1．87±0．05）％；Ki-67值分别为（58．35±2．18）％、（59，73±3．06）％、（62．65±2．24）％，均明显高于对照组（P〈0．05）。缺血再灌注干预各组ALT和AST明显高于对照组（P〈0．05）。术后6h和12h，160R30、190R30和190R60组TNF-α明显高于对照组（P〈0．05）。结论大鼠即将被切除的肝脏先缺血再灌注后切除，对残肝再生具有促进作用；诱导产生的TNF-α表达量增多是促进肝再生的原因之一。Objective To investigate the effects of ischemia reperfusion injury before partial hepatectomy on liver regeneration in rats. Methods Seventy-five male healthy SD rats were randomly classified into 5 groups ： group control, in which rats were only subjected to 70% hepatectomy; group I10R30, 70% liver hepatectomy after 10 min of ischemia and 30 min of reperfusion in the resected liver; By analogy, group I60R30, group I90R30 and group I90R60 were constructed. At 6th., 12th and 24th h after operation, RLW was determined; serum alanine aminotransferase （ALT） and aspartate transaminase （AST） activities were measured by using autoanalyzer; the levels of serum tumor necrosis factor （TNF）-α were determined by ELISA and the expression level of Ki-67 was detected by using immunohistochemical methods in the residual liver tissues. Results At 12th h after partial hepatectomy, the rate of RLW in group I60R30, group I90R30 and group I90R60 was （ 1.80 ±0. 03 ） % , （ 1.82 ±0. 10） % , （ 1.87 ±0. 05 ） % respectively; the rate of Ki-67 was （58.35 ±2. 18）% , （59.73 -＋3.06）%, （62. 65 ±2. 24）% respectively, which was significantly higher than that in the group control （ P 〈 0. 05 ）. The levels of ALT and AST in rats with ischemia reperfusion injury were higher than in the group control （P 〈0. 05）. At 6th h and 12th h after operation, the expression levels of TNF-α in groups I60R30, I90R30 and I90R60 were significantly higher than those in the group control （ P 〈 0. 05 ）. Conclusion Ischemia reperfusion injury in the resected liver before partial hepate, ctomy could improve liver regeneration of the renmant liver in rats. The high expression of induced TNF-α may be one of the reasons.

关 键 词：肝再生 缺血再灌注 肝切除术 

分 类 号：R657.3[医药卫生—外科学]