脾脏缺血预处理对大鼠肝脏缺血再灌注损伤的保护作用  

Remote ischemic preconditioning of spleen decreases hepatic ischemia reperfusion injury in rats

作　　者：申东方[1] 刘超[1] 庞志刚[1] 黄涛[2] 尚闯[1] 何艳新[1] 

机构地区：[1]郑州大学第二附属医院普外科,450014 [2]河南省肿瘤医院肝胆外科

出　　处：《中华实验外科杂志》2013年第12期2580-2582,F0003,共4页Chinese Journal of Experimental Surgery

基　　金：河南省卫生科技创新型人才资助项目（201004121）

摘　　要：目的 探讨远程缺血预处理（RIPC）对肝缺血再灌注损伤（HIRI）的影响及其机制.方法 将36只雄性SD大鼠随机分为3组：假手术组（Sham组）仅行开腹及肝门分离;缺血再灌注模型组（IR组）采用Pringle＇s法阻断肝门15 min,再灌注2h;缺血预处理组（RIPC组）首先阻断脾动脉15 min,放开15 min,后其操作同IR组.各组大鼠在再灌注2h后分别取门静脉血清测谷丙转氨酶（ALT）、谷草转氨酶（AST）;取肝组织作病理学检查、免疫组织化学法肿瘤坏死因子-α（TNF-α）和P-选择素测定.结果 与Sham组比较,血清ALT、AST水平在IR组[（466.75±89.45）、（782.25±87.71） U/L）]和RIPC组[（231.87 ±50.80）、（326.75 ±19.12） U/L]明显升高（P＜0.05）;肝组织病理损伤评分升高（P＜0.05）;肝组织内TNF-α和P-选择素表达升高（p＜0.05）.其中上述指标在RIPC组中水平较IR组均明显降低（P＜0.05）.结论 脾脏缺血预处理可减轻HIRI,分析其原因可能是通过减少黏附因子的表达,减轻中性粒细胞的聚集,从而减少炎性损伤而发挥作用.Objective To investigate the effect and mechanism of remote ischemic preconditioning on hepatic ischemia-reperfusion injury.Methods Thirty six SD rats were divided into three group randomly：Sham-operated group （Sham group）,ischemia-reperfusion group （IR group：produced by total inflow occlusion for 15 min）,and remote ischemic preconditioning group [remote ischemic preconditioning （RIPC） group：induced with 15 min ischemia of spleen before hepatic ischemia].Serum aminotransferases [alanine aminotransferase （ALT）,aspartate aminotransferase （AST）] and tumor necrosis factor （TNF）-α,P-selectin in liver were measured after reperfusion for 2 h.Results Compared with the Sham group,the level of ALT,AST and the pathological injury scores were significantly increased in the IR [（466.75 ± 89.45）,（782.25 ±87.71） U/L and RIPC （231.87 ±50.80）,（326.75 ± 19.12） U/L] groups.TNF-α and p-selectin expression were high when IR only as well.These variables were significant decreased in RIPC group.Conclusion Remote ischemic preconditioning of spleen decreases the reperfusion injury during hepatic ischemia which may be caused by the decrease of pro-inflammatory and activity of neutophils.

关 键 词：缺血预处理 缺血再灌注损伤 肝脏 脾脏 

分 类 号：R363[医药卫生—病理学]