N-乙酰半胱氨酸预处理对肝脏缺血再灌注损伤的保护作用  

Protective effects of NAC preconditioning on hepatic ischemia reperfusion injury

作　　者：庄永敬[1] 曹云飞[1] 薛蓬[1] 刘小红[1] 卢良生[1] 吴桂荣[1] 

机构地区：[1]解放军第421医院普通外科,广东广州510318

出　　处：《肝胆胰外科杂志》2011年第5期360-363,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：国家自然科学基金资助项目(C30000158)

摘　　要：目的探讨N-乙酰半胱氨酸(N-acetylcysteine,NAC)预处理对肝脏缺血再灌注损伤的保护作用。方法18例肝血管瘤手术患者随机分为3组(n=6):对照组(C0)、NAC预处理组(PR)和NAC后处理组(PO),其中PR和PO组分别于肝门阻断前和开放后给予NAC 120 mg/kg。三组患者均于切皮前(T0)、肝门阻断开放后1 h(T1)及6 h(T2)抽血检测谷丙转氨酶活性(ALT)和谷草转氨酶(AST)水平,并于肝门阻断开放后1 h(T1)取肝组织测定丙二醛(MDA)含量及核因子κB(NF-κB)活性。结果肝门阻断开放后1 h(T1)和6 h(T6),各组的ALT和AST水平均明显高于肝门阻断前(T0)水平(P<0.01);与对照组相比,PR和PO组的MDA含量在肝门阻断开放后1 h(T1)明显减少(P<0.01),但NF-κB的活性仅在PR组显示有明显的降低(P<0.01)。结论 NAC预处理可有效防治肝脏缺血再灌注损伤,其机制与抑制再灌注后NF-κB的启动激活有关。Objective To probe the protective effects of N-acetylcysteine（NAC） preconditioning on hepatic ischemia reperfusion injury.Methods Eighteen patients undergone hepatic haemangioma resection were allocated randomly into three groups（n=6）： control group（CO）,NAC preconditioning group（PR） injected with NAC 120 mg/kg before hepatic inflow occlusion（T0）,NAC postconditioning group（PO） with NAC injected after hepatic vascular release.Serum levels of alanine aminotransferase（ALT） and aspartate aminotransferase（AST）were determined separately before skin incision（T0）,at 1 h（T1） and 6 h（T2） after hepatic vascular release.Malondialdehyde（MDA） contents and the activities of nuclear factor-κB（NF-κB） in liver tissue were detected at 1 h after hepatic vascular release.Results The serum levels of ALT and AST at 1 h（T1） and 6 h（T2） after hepatic vascular release increased markedly as compared to those before hepatic inflow occlusion（T0） in all three groups.Compared with that of CO group,the contents of MDA were lower in both PR and PO groups（P〈0.05）,while the reduced binding activity of nuclear factor-κB in liver tissue was only observed in PR group（P〈0.01）,but not in PO group.Conclusion NAC preconditioning can protect hepatic ischemia and reperfusion injury,mainly by inhibiting the trigger of the activation of nuclear factor-κB.

关 键 词：N-乙酰半胱氨酸 肝脏 缺血再灌注损伤 丙二醛 NF-ΚB 

分 类 号：R657.3[医药卫生—外科学]