灌注流量在低温机器灌注保存供体肝的研究  

A study on perfusion flow rate in cold machine perfusion preservation of donor liver

作　　者：张智勇 Zhang Zhiyong(Department of, Shanxi Provincial 109 Hospital, Taiyuan 030006, China)

机构地区：[1]山西省109医院普外科,太原030006

出　　处：《中国药物与临床》2018年第3期316-319,共4页Chinese Remedies & Clinics

基　　金：国家自然科学基金(61373100)

摘　　要：目的通过对比大鼠肝脏在低温机器灌注保存法以及低温缺血保存再灌注保存法下的保存效果,从而证明低温机器灌注保存法的有效性的同时寻找出最佳的灌注流量。方法将大鼠供受体肝脏置于对照组和5个实验组当中分别保存6 h和24 h,实验组设定灌注流量为0.1~0.5 ml·min-1·g-1,其他实验条件保持一致,以丙氨酸转氨酶(ALT)活性,肿瘤坏死因子(TNF-α)含量和透明质酸(HA)摄取量的变化作为评定标准,并分别用光镜和电镜观察肝细胞及肝窦内皮细胞的形态学改变。结果通过与对照组对比发现实验组1,5保存6 h和24 h后,各时间点ALT含量,TNF-α含量和HA摄取量比较差异无统计学意义(P>0.05);而实验组2、3、4保存6 h和24 h后明显低于对照组,差异有统计学意义(P<0.05)。且对照组,实验组1和5保存24 h后肝细胞出现明显肿胀、空泡变性及点状坏死现象,同时肝窦内皮细胞肿胀、变性,肝窦结构破坏严重。实验组2、3、4肝细胞和肝窦内皮细胞较对照组,实验组1和5有较轻的病理改变。结论通过与对照组进行对比说明本文方法的有效性,不同实验组间之间的对比说明最佳的灌注流量范围是0.2~0.4 ml·min-1·g-1。Objective Through the comparison of the preserved effect of rat hepatic in cold storage of Cryo-genic machine perfusion and cold storage of ischemia and reperfusion,it is turned out that the cold storage of is chemia and reperfusion was more effective. At the same time,perfusion flow rate was optimized and determined.Methods The donor liver of rats was placed in the control group and 5 experimental groups preserved for 6 h and24 h. In the experiment,perfusion flow was set as 0.1-0.5 ml·min^-1·g^-1 and other experimental conditions remain the same. The change of the activity of alanine aminotransferase（ALT）, the content of tumor necrosis factor（TNF-α） and the intake of hyaluronic acid（HA） were taken as assessment standards. And morphological changes of hepatocytes and sinusoidal endothelial cells were observed under light microscope and electron microscope respectively. Results Through the comparison of the results of control group and experimental groups,it was turned that,after 6 h of group 1 and 24 h of group 5,there was no significant difference in ALT content,TNF-α content and HA intake at every time.While the results of group 2,3,4 were obviously low than that of control group,and the difference was statistically significant. In experimental group 1 and 5,the hepatocytes showed obvious swelling,vacuolar degeneration and punctate necrosis 24 hours later. At the same time,the hepatic sinusoidal endothelial cells were swollen and degenerated,and the structure of hepatic sinusoid was severely damaged. Compared with control group and experimental group 1 and5,the hepatocytes and sinusoidal endothelial cells in group 2,3,4 have a lighter pathological change. Conclusion The contrast between the experimental groups and the control group shows the effectiveness of the method in the pa-per and that the best perfusion flow range is 0.2-0.4 ml·min^-1·g^-1.

关 键 词：低温机器灌注 灌注流量 肝脏保存 大鼠 

分 类 号：R657.3[医药卫生—外科学]