乌司他丁对肝大部切除合并缺血再灌注损伤后肝再生和能量代谢的影响  

Effect of Ulinastatin on liver regeneration and energy metabolism after major hepatectomy combined with ischemia reperfusion injury

作　　者：谭敬[1] 朱宇麟[1] 周荣胜[1] 张晓琪[1] 赵鸽[1] 刘齐宁[1] 

机构地区：[1]西安交通大学医学院第一附属医院麻醉科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2014年第1期89-93,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省科技攻关项目(No.2008K14-02);天普研究基金(No.012009040)~~

摘　　要：目的探讨乌司他丁(ulinastatin,UTI)预处理对大鼠70%肝切除术合并缺血再灌注损伤后肝再生和能量代谢的影响。方法健康清洁级雄性SD大鼠120只随机分为单纯肝切除组(PH)、肝切除合并缺血再灌注组(PHIR)和乌司他丁组(UTI),每组40只。将各组大鼠肝左、中叶切除,残肝(右、尾叶)作不同处理:PH组不阻断保留肝血流;PHIR组阻断保留肝血流30min后恢复灌注;UTI组与PHIR组肝脏切除及保留肝断流处理相同,但于缺血前5min经尾静脉给予UTI 50 000U/kg。再灌注后1、6、12、24、48h分别取各组大鼠下腔静脉血、肝组织,测定血清ALT和AST,肝细胞凋亡指数(AI);24、48h残肝再生度、PCNA阳性率和ATP、ADP和AMP含量。结果 UTI组的血清ALT和AST活性、AI均低于PHIR组(P<0.05),肝再生度和PCNA阳性率均高于PHIR组(P<0.05),ATP含量和能量负荷较PHIR组明显升高(P<0.05)。结论乌司他丁预处理能促进对大鼠70%肝切除术合并缺血再灌注损伤后的肝再生,其机制与维持能量代谢有关。Objective To investigate the effect of ulinastatin （UTI） pretreatment on liver regeneration and energy metabolism after 70% hepatectomy combined with ischemia reperfusion injury in rats. Methods Totally 120 healthy clean grade male Sprague-Dawley rats weighting 230~280 g were selected and assigned into three groups randomly： simple partial hepatectomy （PH） group, partial hepatectomy combined with ischemia reperfusion （PHIR） group and ulinastatin （UTI） group, with forty rats in each. Rats in each group had the left and middle liver lobes resected, but the remnant lobes （right and caudate lobes） were treated differently as follows： the blood flow to the reserved lobes was not occluded in PH group, but occluded for 30 minutes in PHIR group, and then reperfused. UTI group had the same liver resection and blood flow occlusion as PHIR group except for administration of ulinastatin 50 000 U/kg by i.v. injection via caudal vein. Inferior vena cava blood and the reserved liver tissue were collected to measure serum alanine transaminase （ALT） and aspartate aminotransferase （AST）, apoptosis index （AI）, regenerated liver weight, PCNA staining as well as ATP, ADP and AMP contents. Results Serum ALT and AST activities and AI level were lower, and the regenerated liver weight and positive PCNA staining as well as ATP content and energy charge were significantly higher in UTI group than in PHIR group （P-（0.05）. Conclusion Ulinastatin can promote liver regeneration after major hepatectomy combined with ischemia reperfusion injury, which is possibly related to maintaining energy metabolism.

关 键 词：肝脏 缺血再灌注损伤 肝再生 乌司他丁 能量代谢 细胞凋亡 

分 类 号：R971.2[医药卫生—药品]