中度脂肪肝对原位自体肝移植模型大鼠心脏功能的影响  

Effect of moderate fatty liver on cardiac function in orthotopic autologous liver transplantation model rats

作　　者：王楷文 董河[1] 吕琳[1] 刘欢[1] 蔡金贞 WANG Kaiwen;DONG He;LYU Lin;LIU Huan;CAI Jinzhen(Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266003

出　　处：《精准医学杂志》2024年第2期139-143,共5页Journal of Precision Medicine

基　　金：青岛市医药卫生科研计划项目(2021-WJZD198)。

摘　　要：目的探究中度脂肪肝对原位自体肝移植模型大鼠心脏功能的影响。方法将60只SPF级健康雄性SD大鼠随机分为3组(每组20只)。A组喂养普通饲料6周,开腹后游离肝脏周围血管及韧带后关腹;B组喂养普通饲料6周,实施原位自体肝移植手术;C组喂养高脂饲料6周,实施原位自体肝移植手术。比较各组大鼠饲养6周后的体质量、肝湿质量、肝指数及血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)的水平,比较各组大鼠术中血压、脉搏、呼吸频率、新肝期心律失常发生比例以及新肝期0、5、10、60 min时血清乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、高敏肌钙蛋白(hs-cTn)等指标水平。结果C组大鼠的体质量、肝湿质量、肝指数、血清AST水平、血清ALT水平及术中收缩压、舒张压、脉搏、呼吸频率、新肝期心律失常发生比例显著高于A、B组(F=36.40~4060.54,χ^(2)=10.91,P<0.05),A、B组大鼠上述指标无明显差异(P>0.05)。C组大鼠新肝期不同时刻血清LDH、α-HBDH、CK、CK-MB、hs-cTn水平均显著高于A、B组(F=14.11~1057.08,P<0.05),且B组显著高于A组(F=12.59~279.94,P<0.05)。结论中度脂肪肝可能导致肝移植新肝期心律失常的发生,降低心脏功能,加剧术中应激反应。Objective To explore the effect of moderate fatty liver on cardiac function in orthotopic autologous liver transplantation model rats.Methods Sixty SPF-grade healthy male SD rats were randomly divided into three groups(20 rats in each group).Group A was fed ordinary diet for 6 weeks and underwent laparotomy followed by separation of the blood vessels and ligaments around the liver and abdominal closure;group B was fed ordinary diet for 6 weeks and underwent orthotopic autologous liver transplantation;group C was fed high-fat diet for 6 weeks and underwent orthotopic autologous liver transplantation.The body mass,liver wet mass,liver index,and serum levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)after 6 weeks of feeding,as well as intraoperative blood pressure,pulse rate,respiratory rate,proportion of arrhythmia occurring in the new liver stage,and serum levels of lactate dehydrogenase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),and high-sensitivity cardiac troponin(hs-cTn)at 0,5,10,and 60 min in the new liver stage were compared.Results The body mass,liver wet mass,liver index,and serum AST and ALT levels,as well as intraoperative systolic blood pressure,diastolic blood pressure,pulse rate,respiratory rate,and proportion of arrhythmia occurring in the new liver stage in group C were significantly higher than those in groups A and B(F=36.40-4060.54,χ^(2)=10.91,P<0.05),with no significant differences between groups A and B(P>0.05).The serum levels of LDH,α-HBDH,CK,CK-MB,and hs-cTn at different time points in the new liver stage were significantly higher in group C than in groups A and B(F=14.11-1057.08,P<0.05),and were significantly higher in group B than in group A(F=12.59-279.94,P<0.05).Conclusion Moderate fatty liver may lead to the occurrence of arrhythmia in the new liver stage in liver transplantation,reduce cardiac function,and exacerbate intraoperative stress response.

关 键 词：肝移植 移植 自体 脂肪肝 肝功能试验 心律失常 心性 乳酸脱氢酶类 羟丁酸脱氢酶 肌酸激酶 同工酶类 肌钙蛋白 

分 类 号：R657.3[医药卫生—外科学]