治疗性高碳酸血症对大鼠移植肝脏缺血再灌注损伤的影响  

Effect of therapeutic hypereapnia on hepatic ischemia-reperfusion injury in rat liver transplantation

作　　者：崔晓光[1] 张丽娟[1] 谭晶[1] 郭悦平[1] 李文志[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科黑龙江省麻醉与危重病学研究重点实验室,150086

出　　处：《中华麻醉学杂志》2011年第11期1366-1369,共4页Chinese Journal of Anesthesiology

基　　金：黑龙江省教育厅科学技术研究项目（1151G028）

摘　　要：目的探讨治疗性高碳酸血症对大鼠移植肝脏缺血再灌注损伤的影响。方法清洁级雄性Wistar．大鼠32只，6周龄，体重220～280g，采用完全随机设计的方法两两配对实施肝脏原位移植16只。采用随机数字表法，将受体鼠随机分为2组（n=8）：肝移植组（LT组）和治疗性高碳酸血症组（TH组）。LT组再灌注即刻吸入50％02—50％N1混合气体2h；TH组再灌注即刻吸入O2-M-CO2混合气体1h，调节气体浓度和呼吸频率，维持FiO250％、PaCO280～100mrnHg，而后继续吸人50％02—50％N1混合气体1h。再灌注期间记录MAP、PaO2和PaCO2。再灌注2h时，取动脉血样，测定血清ALT、AST、TNF-α、IL-1和IL-6的水平；取肝组织，测定NF-KB活性，计算凋亡指数，观察肝组织病理学结果。结果与LT组比较，TH组血清ALT、AST、TNF-α、IL-1和IL-6水平、肝组织NF-κB活性和凋亡指数降低，MAP、PaO1和PaCO2升高（P〈0．05）。TH组肝组织病理学损伤较LT组减轻。结论治疗性高碳酸血症可减轻大鼠移植肝脏缺血再灌注损伤，机制与抑制炎性反应和细胞凋亡有关。Objective To investigate the effect of therapeutic hypercapnia on hepatic ischemia-reperfusion （I/R） injury in rat liver transplantation. Methods Male specific pathogen-free adult Wistar rats aged 6 weeks weighing 220-280 g were used in this study. Sixteen rats in which liver transplantation was successfully performed were randomly divided into 2 groups （n = 8 each） ： liver transplantation group （group LT） and therapeutic hyper capnia group （group TH）. In group TH, PaCO2 was maintained at 80-100 mm Hg by inhalation of CO2 for 1 h at the begining of reperfusion. MAP, PaO2 and PaCO2 was recorded during reperfusion. Blood samples were obtained at 2 h of reperfusion for determination of serum ALT, AST, TNF-α, IL-1 and IL-6 levels, and then the rats were sacrificed and transplanted liver was immediately removed for determination of NF-κB activity and apoptosis and mi- croscopic examination. The apoptotic index was calculated.Results MAP, PaO2 and PaCO2 were higher, and se- rum ALT, AST, TNF-α, IL-1 and IL-6 levels, NF-κB activity and apoptotic index lower in group TH than in group LT （ P 〈 0.05）. The histopathologic damage was ameliorated in group TH as compared with group LT. Conclusion Therapeutic hypercapnia can attenuate hepatic I/R injury in rat liver transplantation by inhibiting inflammatory response and apoptosis.

关 键 词：高碳酸血 肝移植 再灌注损伤 

分 类 号：R657.3[医药卫生—外科学]