肝脏低温保存肝血窦变化的实验观察  

Experimental study on changes of liver sinusoids during hypothermic storage

作　　者：熊成龙[1] 姚峰[1] 涂毅[1] 陈孝平[2] 吴在德[2] 

机构地区：[1]武汉大学人民医院普通外科,430060 [2]华中科技大学同济医学院附属同济医院普外科

出　　处：《中华实验外科杂志》2003年第1期27-28,共2页Chinese Journal of Experimental Surgery

摘　　要：目的　探讨低温保存肝血窦超微结构的变化及其在肝微循环障碍中的作用。方法　将 6 3只大鼠肝脏分别在低温UW液中保存 0 (对照组 )、2、8、16、2 4、32和 48h ,然后对肝血窦进行电镜观察。结果　肝血窦内皮细胞在保存 2、8h后 ,筛板小孔扩大、融合成许多大洞隙 ,16、2 4h细胞明显回缩 ,呈树根状 ,32、48h似索网状 ,部分内皮细胞突起、脱落。肝细胞微绒毛在保存 8h后出现肿胀并形成膜浆泡从扩大的内皮小孔突入血窦 ;随着保存时间延长 ,膜浆泡增多、变大并脱落或破裂。结论　肝血窦内皮细胞的低温保存损伤和膨入血窦内的膜浆泡可引起肝微循环紊乱 ,导致肝血流和肝功能障碍。Objective To study the ultratrutural changes in rat liver sinusoids during hypothermic storage and the role of them in liver microcirculatory disturbance.Methods Sixty-three rats were used.Liver were preserved for 0 (controls),2,8,16,24,32 and 48 h in UW solution at 4 ℃ respectively.Electron microscopy was made for liver sinusoids.Results The first preservation damage was noted in endothelial cell.After 2 h of storage,enlarged and ruptured fenestrae with many gaps were observed.Then the endothelial cells became swollen at 8 h,stringlike at 16,24 h and retracted at 32,48 h,leading to stripped sinusoidal walls.Furthermore,the cytoplasmic blebs stemming from the microvilli of hepatocytes were seen in sinusoidal lumen after 8 h of storage,then enlarged and ruptured duringlonger storage.It was significantly less at 24 h than at 48 h (P<0.05).Conclusion The changes of endothelial cells and bleb formation could result in liver sinusoidal obstraction and disruption of the microcirculation.

关 键 词：低温保存 再灌注损伤 肝血窦 肝移植 超微结构 

分 类 号：R657.3[医药卫生—外科学]