不同时间的缺血预处理对脂肪肝缺血再灌注损伤的保护作用  

The protective effect of different-time-ischemic preconditioning on the reperfusion injury in fatty livers in rats

作　　者：汤建军[1] 江勇[2] 罗光华[3] 远博[2] 

机构地区：[1]常州市武进人民医院肝胆外科,江苏常州213003 [2]常州市第一人民医院肝胆外科,江苏常州213003 [3]常州市第一人民医院综合实验室,江苏常州213003

出　　处：《临床肝胆病杂志》2011年第12期1308-1311,共4页Journal of Clinical Hepatology

基　　金：江苏省卫生厅面上科研课题(H200870);常州市卫生局重大招标项目(ZD200811);江苏省常州市社会发展项目(CS2008912)

摘　　要：目的探讨缺血预处理(IP)对脂肪肝缺血再灌注(IR)损伤的保护作用,以及取得最佳效果的预处理时间。方法通过建立大鼠脂肪肝模型,给予不同时间的IP(5-10、8-10、10-10、15-10 min)和IR(缺血30 min,再灌注30 min),检测血清AST、ALT、LDH及NO水平,肝组织中MDA、SOD、MPO含量的变化和肝脏病理学变化。以脂肪肝未行IP组和正常肝脏未行IP组及正常肝脏行10-10 min IP作对照。结果 IR后,脂肪肝未行IP组血清肝功能的变化、肝组织病理学改变及炎性浸润程度显著重于正常肝脏未行IP组。在脂肪肝组中,5或8-10 min IP组血清学及肝组织MDA、MPO水平低于其余组和未行IP组,而其SOD水平显著升高(P<0.05)。各IP组中的NO水平明显高于其对应的IR组(P<0.05)。脂肪肝IP组中,5或8-10 min IP组血清NO水平明显高于其余组(P<0.05)。结论脂肪变性加重肝脏IR损伤,IP对脂肪肝的IR损伤具有保护作用,本实验认为5～8 min缺血和10 min再灌注的IP方案可能是中重度脂肪肝时的最佳预处理方案。Objective To elucidate the protective effect and potential mechanisms of preconditioning on hepatic IR injury in steatotic livers and explore the optimal ischemic time. Methods The fatty liver model was made by feeding high - fat diet. The changes in serum and in liver sample were evaluated for the different isehemic time of preconditioning liver. Histological analyses of liver were performed and hepatic fatty infiltration were evaluated by sudan Ⅲ stain. Results 1. The preconditioning consisting of 15 minutes of isehemia followed by 10 minutes of reperfusion was performed （ 15 min ＋ 10 win IP）. The extent and number of necrosis areas at 24 hours after hepatic reperfusion was markedly increased in fatty livers. By contrast, the histological study in normal liver showed moderate. 2. The level of serology and the changes of MDA, MPO in liver in 5 or 8 - 10 min preconditioning group were lower than the other preconditioning groups in fatty liver, while the SOD activity level was significantly higher than the others （ P 〈 0.05 ）. The serological level of NO in IP group was significantly higher than the corresponding IR group （ P 〈 0.05 ）. In fatty liver group, the level of NO in 5 or 8 - 10 min IP group was significantly higher than the others （ P 〈 0.05 ）. Conclusion Liver with fat infiltration can aggravate isehemia - reperfusion injury in rats. Ischemia preconditioning can also increase the tolerance of fatty liver induced by high - fat diet to hepatic ischemia - reperfusion injury in rats. The protective effect of ischemia preconditioning is distinct in different ischemic time of preconditioning, and the 5 -8 rain and 10 rain IP was superior to the others.

关 键 词：脂肪肝 缺血预处理 再灌注损伤 

分 类 号：R575.5[医药卫生—消化系统]