腹腔神经丛阻滞对肝部分切除术后肝细胞凋亡的影响  

Effect of neurolytic celiac plexus block on hepatocellular apoptosis after partial hepatectomy in rats

作　　者：李军[1] 车建翔[2] 魏晓红[3] 邱庆明[2] 林露[1] 白树荣[1] 潘璠[1] 孙小琴[1] 

机构地区：[1]成都军区总医院麻醉科,四川610083 [2]解放军44医院麻醉科,贵州贵阳550009 [3]成都军区总医院心血管外科,四川610083

出　　处：《创伤外科杂志》2014年第1期50-53,共4页Journal of Traumatic Surgery

基　　金："十二五"成都军区医学科学技术研究项目(c12005);成都军区总医院院管课题(2011YG-B010)

摘　　要：目的观察腹腔神经丛阻滞(NCPB)对肝部分切除术(PH)大鼠残余肝细胞凋亡的影响。方法60只清洁雄性SD大鼠,构建大鼠70%PH模型,随机分为对照组和NCPB组。NCPB组在术后12h开始给予双侧0.5%利多卡因经皮NCPB,1次/d,而对照组以0.9%生理盐水替换。分别于术后第1、3、7d测定残肝功能、血流量和凋亡相关蛋白Bcl-2相关X蛋白(BAX)和B细胞淋巴瘤/白血病-2(Bcl-2)的表达。结果NCPB组大鼠的谷草转氨酶(AST)和谷丙转氨酶(ALT)在PH术后第1、3、7d均不同程度地低于对照组(P<0.01或P<0.05);对照组PH术后肝细胞出现明显的脂肪变性,且较多见小灶性肝细胞坏死和小片状肝细胞坏死,而NCPB组肝组织变性坏死明显减轻;与对照组相比,NCPB组大鼠的肝脏血流量在各个时间点均显著高于对照组(P<0.01);PH术后两组肝组织BAX均逐渐下降,但在相应时间点NCPB组显著低于对照组(P<0.05或P<0.01),而Bcl-2显著升高,但NCPB组却显著高于对照组(P<0.01),在第3d和第7d NCPB组的BAX/Bcl-2比值显著低于对照组(P<0.01)。结论 NCPB减轻大鼠PH术后早期肝功能损害,可能与抑制PH术后早期肝细胞凋亡有关。Objective To investigate the effects of neurolytic celiac plexus block（ NCPB } on the apoptosis of residual liver ceils after partial hepatectomyl PH） in rats. Methods Sixty clean male SD rats were randomly di vided into control group and NCPB group after 70% PH. NCPB group received pertaneous neurolytic celiac plexus block with 0. 5 % lidocaine（ one time/day） , and control group received the same procedures, but physiological saline was injected instead of 0. 5% lidocaine. The residual liver function, liver blood flow and expressions of apoptosis related protein BAX and Bcl2 were determined at 1 day,3 days arid 7 days after PH. Results The aspartate amin otransferase （ AST} and alanine aminotransferase （ ALT } content of PH rats in the NCPB group was significantly low er than that of rats in control group at 1 day,3 days and 7 days （ P 〈0. O1 or P 〈0. 05 ）. The hepatocytes showed more steatosis, and spotty or patchy necrosis after PH in the control group than in the NCPB group. At all the re spective time points, the liver blood flow of the NCPB group was higher than that of the control group { P 〈 0. O1 ）. The hepatic BAX expressions were gradually decreased in the two groups after PH, but at the corresponding time point it was significantly lower in NCPB group than that of the control group （ P 〈 0. 05 or P 〈 0. O1 ）. The Bcl2 ex pressions were increased significantly ,which was remarkably higher in the NCPB group than that in the control group （ P 〈0. O1 ）. At 3 days and 7 days,the BAX/Bcl2 ratio was significantly lower in NCPB group than that in the con trol group（ P 〈 0. 01 ）. Conclusion NCPB treatment can alleviate the early damage of liver function after PH in rats, which may be associated with the inhibition of hepatocellular apoptosis.

关 键 词：腹腔 神经丛阻滞 肝切除 肝细胞 凋亡 

分 类 号：R657.3[医药卫生—外科学]