应用激光扫描共聚焦显微镜技术实时评估大鼠冷缺血损伤肝脏的质量  

Real-time assessments of liver quality in cold ischemia injury based on the technique of laser scanning confocal microscope

作　　者：方旭 蒋忠仪 李蕾 沃琪 钟林[1] Fang Xu;Jiang Zhongyi;Li Lei;Wo Qi;Zhong Lin(Depaartment of General Surgery, First Municipal People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China)

机构地区：[1]上海交通大学附属第一人民医院普外科,200080

出　　处：《中华器官移植杂志》2019年第5期303-307,共5页Chinese Journal of Organ Transplantation

基　　金：国家重点研发计划项目(2016YFC0104106).

摘　　要：目的探讨应用激光扫描共聚焦显微镜技术(LSCM)及肝脏生化指标检查实时评估大鼠冷缺血损伤肝脏质量的价值。方法采用SD大鼠构建肝脏冷缺血模型,依据冷缺血时间(CIT)的不同将大鼠分为4组,分别为CIT1 h组、CIT6 h组、CIT12 h组及CIT24 h组。采集各组大鼠肝脏的保存液及灌洗液检测肝功能相关指标丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)及乳酸脱氢酶(LDH)。结果LSCM检查和肝组织病理切片检查结果均显示,随着冷缺血时间的延长,肝脏质量显著下降。在肝脏的保存液及灌洗液中的临床指标检测的结果显示,只有LDH的差异具有统计学意义(P<0.001)。结论LSCM能够在离体肝脏中观察到与病理组织切片相似的结果,操作简单及时效性是激光扫描共聚焦显微镜的一个显著的优点。LDH指标比ALT及AST具有更好的预测性作用。Objective To assess the quality of donor liver allografts by employing laser scanning confocal microscope (LSCM) and clinical liver function tests. Methods Sprague-Dawley rats were used for establishing cold ischemia models of liver allografts. According to different timepoints of cold ischemia, four groups of CIT1h, CIT6h, CIT12h and CIT24h were designated. At the end of cold ischemia time (CIT) of each group, perfusion and preservation fluids were collected and fluoresceins perfused. After LSCM examinations, tissue samples were harvested for HE examination. Finally a comparison was made between LSCM results and hematoxylin & eosin (HE) examinations. Also some relevant clinical parameters were detected in preserving and flushing fluids. Results Both LSCM examination and pathological examination indicated that the quality of liver allografts decreased significantly with the elapsing of time. Only the difference of LDH was statistically significant (P<0.001). Conclusions LSCM may be used for evaluating the ex vivo qualities of liver allografts. Simple handling and time efficiency re great advantages of LSCM. As compared with alanine transaminase (ALT) and aspartate transaminase (AST), LDH is a better indicator reflecting the quality of liver allografts.

关 键 词：供者 肝脏 冷缺血 激光扫描共聚焦显微镜 评估 肝功能 乳酸脱氢酶 

分 类 号：R657.3[医药卫生—外科学]