一氧化氮在大鼠小肠移植缺血再灌注损伤和急性排斥反应中的作用  

The nitric oxide in ischemia-reperfusion injury and acute rejection of rat intestinal transplantation

作　　者：李晓林[1] 邹小明[1] 李刚[1] 宋茂力[1] 聂刚[1] 姜浩[1] 

机构地区：[1]哈尔滨医科大学附属二院普外科,150086

出　　处：《中华器官移植杂志》2012年第1期48-52,共5页Chinese Journal of Organ Transplantation

基　　金：哈尔滨市科技攻关计划项目（2005AA9CS116-7）

摘　　要：目的探讨一氧化氮（NO）在大鼠小肠移植缺血再灌注损伤（IRI）和急性排斥反应（AR）中作用。方法建立同种大鼠原位小肠移植模型，采用随机数字表法将受鼠分为4组。移植对照组、左旋精氨酸（L-Arg）组、左旋硝基精氨酸甲酯（L_NAME）I组（I组）和L-NAMEII组（Ⅱ组）受鼠于手术当天开始分别每天给予生理盐水、L-Arg150mg·kg^-1·d^-1、L-NAME4和8mg·kg^-1·d^-1。术后观察各组受鼠的存活时间，行HE染色观察移植小肠的组织病理学改变，采用免疫组织化学法观察移植小肠一氧化氮合酶（NOS）的活性，以及检测血糖吸收功能和血清NO浓度。结果移植对照组、L_Arg组、I组及Ⅱ组受鼠的存活时间分别为（11．7±1．2）d、（10．2±1．0）d、（12．3±1．5）d和（17．3±1．9）d，Ⅱ组受鼠的存活时间明显延长（P〈0．01）。与移植对照组相比，L_Arg组和I组IRI的Park评分下降，IRI减轻；II组Park评分显著升高（P〈0．01），IRI加重，但AR明显减轻。与移植对照组相比，IRI期间，I组iNOS染色减弱，Ⅱ组iNOS和nNOS染色均减弱；AR期间，Ⅱ组iNOS染色明显减弱。各组血清NO浓度于再灌注后30min逐渐升高。与移植对照组相比，Ⅱ组血NO浓度的升高延缓。与移植对照组相比，L-Arg组血糖吸收值于再灌注30min至术后3d明显增高（P〈0．01）；工组和Ⅱ组血糖吸收值术后处于较低水平。结论NO在大鼠小肠移植IRI中起到了细胞毒和细胞保护的双重作用；在AR中加重了组织损伤。术后早期补充L-Arg可促进移植肠管对糖类的吸收。Objective To evaluate the role of nitric oxide （NO） in ischemia reperfusion injury （IRI） and acute rejection （AR） of intestinal transplantation in rats. Methods The rat orthotopic intestinal transplantation was performed. Animals were assigned to the following 4 groups with random methods： transplant control group, L-arginine （L-Arg） group, NG-Nitro-L-arginine methyl ester （L-NAME） I group （group I ） and L-NAME Ⅱ group （group Ⅱ ）. The rats in different group were given saline, L-Arg （150 mg.kg d-： ）, L-NAME （4 and 8 mg.kg-1 .d-1） injection respectively from the operative day. The recipient survival time was observed. The pathologic changes were observed by HE staining. The activity of nitric oxide synthases （NOS） was measured by using immunohistochemistry. The abilities of glucose absorption and serum NO levels were tested. Results The recipient survival timein transplant control group, L-Arg group, group I and group Ⅲ were （11.7±1.2）, （10.2±1.0）, （12.3±1.5） and （17.3±1.9） days respectively, and the survival in group Ⅱ was prolonged significantly （P〈0. 01）. As compared with control group, the Park scores in L-Arg group and group I were reduced, and IRI were attenuated; the Park score in group Ⅱ was increased （P〈0. 01）, the IRI was aggravated, but the AR was attenuated. As compared with control group, during the IRI period, the iNOS staining in group I was decreased, and both iNOS and nNOS staining in group 11 was decreased; during the AR period, the iNOS staining in group II was decreased obviously. The serum NO levels were increased gradually in all groups. As compared with control group, the increase of serum NO level in group II was delayed. As compared with control group, the glucose absorption levels in L-Arg group were increased significantly from 30 min after reperfusion to POD-3 （P〈0. 01）, and the postoperative glucose absorption levels in groups I and Ⅱ maintained the low levels. Conclusion NO may play a dual

关 键 词：大鼠 小肠移植 一氧化氮 再灌注损伤 移植物排斥 

分 类 号：R656.7[医药卫生—外科学]