淤血/再灌注损伤对大鼠术后剩余肝脏的影响  

Influences of congestion/reperfusion injury on remnant liver in rats after hepatectomy

作　　者：谭晓宇[1] 许文犁[1] 葛新兰[1] 李崇辉[1] 张爱群[1] 董家鸿[1] 

机构地区：[1]解放军总医院肝胆外科//全军肝胆外科研究所,北京100853

出　　处：《南方医科大学学报》2013年第3期332-337,共6页Journal of Southern Medical University

基　　金：国家自然科学基金(81271738);国家科技支撑计划(2012BAI06B01)~~

摘　　要：目的观察淤血/再灌注损伤(CRI)与缺血/再灌注损伤(IRI)对术后剩余肝脏的影响。方法将雄性SD大鼠分为3组,IRI组:预先对肝左叶进行30 min入肝血流阻断,然后切除除左叶以外的其他肝叶(切除部分约占全肝重的70%);CRI组:预先对肝左叶进行30 min出肝血流阻断,然后切除除左叶以外的其他肝叶;对照组:单纯切除除肝左叶以外的其他肝叶。记录各组大鼠死亡率,分别于术后1、3、7 d处死实验大鼠检测各组的ICG血浆消除率(ICG-PDR)、ALT、AST、肝再生度、Ki-67标记指数等变化。结果 CRI组术后死亡率高于IRI组(34.3%vs 8%,P<0.05)以及对照组(34.3%vs 4%,P<0.01);与对照组相比较,CRI组术后第1天转氨酶明显升高、肝功能显著降低(P<0.05),而同等时间的IRI无统计学差异(P>0.05);与对照组相比,CRI组的术后第1天的Ki-67标记指数明显降低(P<0.01),甚至低于IRI组(P<0.01);CRI组的Ki-67标记指数峰值延迟出现,峰值的高度低于对照组。相比对照组,CRI组术后第3天的肝再生度也受到抑制(P<0.01),亦低于IRI组(P<0.05)。结论与IRI相比,CRI能引起更严重的肝损伤同时抑制肝切除术后早期的肝再生。Objective To observe the effect of congestion/reperfusion injury （CRI） and ischemia/reperfusion injury （IRI） on remnant liver in rats after hepatectomy. Methods Male SD rats were divided into IRI, CRI, and control groups. In the former two groups, the left lateral lobe of the rats were subjected to IRI or CRI for 30 min with the rest lobes （about 70% of the total liver weight） resected; the rats in the control group received hepatectomy preserving only the left lateral lobe. The mortality rate of the rats was recorded, and the surviving rats were sacrificed at 1, 3 and 7 days after operation for analyses of ICG plasma disappearance rate （ICG-PDR）, ALT, AST, liver regeneration rate, and Ki-67 labeling index. Results The mortality rate was significantly higher in CRI group （34.3%） than in IRI group （8%, P〈0.05） and control group （4%, P〈0.01）. On day 1 following hepatectom）~ CRI group showed significantly higher liver enzyme levels and poorer liver functions than the control group （P〈0.05） without significant differences from those in IRI group （P〉0.05）; Ki-67 labeling index in CRI group was significantly lower than that in the control group （P〈0.01） and IRI group （P〈0.01）. Compared with the control group, CRI group showed a significantly lowered maximum Ki-67 labeling index with also a delayed occurrence （P〈0.01）; CRI resulted in poorer liver regeneration rate on day 3 after hepatectomy compared to the control group （P〈0.01） and IRI （P〈0.05）. Conclusion Compared with IRI, CRI can result in severer liver damage and lowered liver regenerative capacity in rats early after hevatectomv.

关 键 词：淤血 再灌注 缺血 再灌注 肝切除 肝损伤 肝再生 

分 类 号：R657.3[医药卫生—外科学]