大鼠肝脏热缺血损伤后组织学与超微结构变化的动态观察  

Hepatic warm ischemia injury in rats:a dynamically histological and ultrastructural study

作　　者：何晓顺[1] 马毅[1] 陈规划[1] 黄洁夫[1] 吴金浪[2] 胡瑞德[3] 梁英杰[3] 

机构地区：[1]中山医科大学附属第一医院器官移植中心,广州510080 [2]中山医科大学电镜室 [3]中山医科大学病理科

出　　处：《中华实验外科杂志》2002年第3期249-251,共3页Chinese Journal of Experimental Surgery

基　　金：卫生部临床学科重点资助项目( 970 4 0 2 30 );广东省科委攻关项目(99M 0 4 90 2G)

摘　　要：目的　观察大鼠肝脏热缺血损伤后组织学与超微结构的动态变化特点 ,探讨肝脏耐受热缺血的安全时限。方法　对 42例不同热缺血时间条件下的大鼠肝脏标本进行组织学、组织化学与超微结构变化的动态观察。结果　光镜下 ,热缺血 30min以后 ,开始出现肝细胞轻度水肿 ,灶性的空泡变性 ,并随热缺血时间的延长而加重 ,未见明显坏死。电镜下可见 ,线粒体肿胀尤为明显 ,但直至热缺血 60min ,大部分细胞仍为可逆性变化 ,仅少数细胞出现染色质边集、核碎裂和核溶解等。组织化学染色显示 ,热缺血 30min始出现肝糖原颗粒减少 ,并有逐渐加重趋势。琥珀酸脱氢酶、细胞色素氧化酶和三磷酸腺苷酶在热缺血 60min后才发生明显的酶活性降低。结论　从组织学与超微结构方面证实 ,肝脏在单纯热缺血损伤时 ,缺血时间在 60min以内 ,肝细胞损伤大多仍处在可复性阶段 。Objective To investigate the histological and ultrastructural characteristics of hepatic warm ischemia injury in rats and predict the tolerance time limitation to hepatic warm ischemia of liver graft.Methods Fourty two rats underwent warm ischemia of different durations and all specimens were investigated dynamically by light and electron microscopy,glycogen stain and histochemistry stain.Results Under light microscopy,hepatocyte cell plasma rarefaction,slight edema and local vacuolation were found 30 min after warm ischemia.These changes were worsened with the prolongation of warm ischemia time.No obvious hepatocyte necrosis was noted in any liver specimen.Ultrastructurally,mitochondrion swelling was obvious by dynamic observation.Most cells showed reversible change,but only a few showed chromatin agglutination in the edge area,karyolysis or karyorrhexis till 60 min.Histochemistry stain showed that hepatocyte glycogen granules were decreased 30 min after warm ischemia and gradually worsened.Succinic dehydrogenase,cytochrome oxidase and apyrase showed reduction of enzyme activity after 60?min.Conclusion Histologically and ultrastructurally,single warm ischemia within 60 min could result in reversible hepatocyte injury mostly,and only a few lead to irreversible injury.

关 键 词：大鼠 肝脏热缺血损伤 组织学 超微结构 动态观察 

分 类 号：R657.3[医药卫生—外科学]