缺血预处理对肝脏缺血再灌注损伤中内毒素血症的影响  

Effect of ischemic preconditioning on endotoxemia during ischemia/reperfusion injury in rat liver

作　　者：张效杰[1] 曹晖[2] 凌伟[2] 吴志勇[2] 邝耀麟[2] 

机构地区：[1]山西医科大学第一医院,030001 [2]上海第二医科大学附属仁济医院,200001

出　　处：《中华普通外科杂志》2000年第1期50-53,共4页Chinese Journal of General Surgery

摘　　要：目的　探讨肠源性内毒素在肝脏缺血再灌注损伤中的作用以及缺血预处理对肠源性内毒素的影响。方法　将 30只Wistar大鼠随机分成 3组 (每组 10只 ) :缺血再灌注组 (ischemia/reperfu sion ,I/R)、缺血预处理组 (ischemicpreconditioning ,IPC)和正常对照组。用自动生化仪测定各组丙氨酸转氨酶 (ALT)和乳酸脱氢酶 (LDH) ;用鲎试剂法测定血浆内毒素 ;用免疫组织化学方法结合图像分析仪对肝组织中内毒素进行定位和半定量分析。结果　I/R组和IPC组ALT和LDH均高于正常对照组 ,而IPC组上述两项指标均低于I/R组。I/R组血浆内毒素水平明显高于正常对照组〔(2 84± 0 5 0 )vs.(0 6 8± 0 14) ,P <0 0 0 1〕 ,而IPC组内毒素水平与I/R组相比较显著下降〔(1 6 5± 0 15 )vs.(2 84±0 5 0 ) ,P <0 0 0 1〕。肝脏内毒素免疫荧光染色I/R损伤组肝细胞胞浆内有广泛的强阳性荧光出现 ;而IPC组大鼠肝细胞内有局限的内毒素阳性荧光存在 ,荧光强度弱于I/R损伤组。用图像分析仪进行半定量分析 ,结果为I/R损伤组和IPC组肝组织内内毒素免疫荧光染色阳性面积都明显高于对照组〔(37 7± 9 6 )vs .(7 4± 0 5 ) ;(17 4± 1 4)vs.(7 4± 0 5 )〕 ,组间比较差异有显著意义 (P <0 0 0 1) ,IPC组内毒素免疫荧光染色阳性面积?Objective[WT5”BZ] To study the effect of intestinal endotoxin on liver ischemia/reperfusion (I/R) injury and protection of ischemic preconditioning (IPC) from liver ischemia/reperfusion injury.[WT5”HZ]Methods[WT5”BZ] 30 wistar rats were divided into three groups: I/R group,IPC group and normal group. In all groups, serum ALT and LDH were examined, endotoxin in the liver tissue were quantitatively analyzed and located by immunocytochemical technique combined with image analysis method.[WT5”HZ]Results[WT5”BZ] Serum ALT and LDH in either I/R or IPC group were higher than in normal group,but in IPC group they were lower than in I/R group. Plasma endotoxin in I/R group was higher than in normal group (2.84±0.50 vs. 0.68±0.14, P <0.001),but in IPC group it was lower than in I/R group (1.65±0.15 vs. 2.84±0.50, P <0.001).There was intensive positive endotoxin immunofluoresence in hepatic cytoplasma in I/R group but focal positive endotoxin immunofluoresence in IPC group. Image analysis indicated that positive areas of endotoxin immunofluoresence both in I/R and IPC group were more than in normal group(37.7±9.6 vs. 7.4±0.5, 17.4±1.4 vs. 7.4±0.5, P <0.001),but in IPC group they were lower than in I/R group(17.4±1.4 vs. 37.7±9.6, P <0.001).[WT5”HZ]Conclusions[WT5”BZ] Intestinal endotoxin participated in liver ischemia/reperfusion injury, preconditioning may ameliorate endotoxaemia and protect the liver from ischemia/reperfusion injury.

关 键 词：再灌注损伤 肝缺血 内毒素血症 缺血预处理 

分 类 号：R602[医药卫生—外科学]