缺血再灌注期间供肝的能量代谢变化及意义  

Change of Energy State in Rabbit Donor Liver during Ischemia-reperfusion Period.

作　　者：王雨[1] 田伏洲[1] 汤礼军[1] 黄大熔[1] 李小军[1] 尹致良[1] 

机构地区：[1]成都军区总医院全军普外中心,成都610083

出　　处：《成都军区医院学报》2002年第4期1-3,共3页

摘　　要：目的 研究缺血再灌注期间供肝以能量代谢的特点及其对供肝功能的影响。方法 将供体兔均分为三组,分别作相应处理:A组(n=7)术前禁食24小时;B组(n=7)正常喂食;C组(n=7)正常喂食+葡萄糖补充。利用自创的兔肝保存——再灌注模型,测定缺血再灌注期间肝糖原水平、肝功酶学水平(AST,ALT,AKP)、ATP及能量负荷(EC)的变化,并在先镜下观察肝组织结构的变化。结果 经冷存6小时后,各组肝糖原水平ATP及EC水平均显著下降,于复温末降至最低点,经再灌注24小时,B、C组有不同程度的恢复,而A组无变化。于再灌注15′,B、C组肝功能酶学水平均升至最高,而后逐渐下降至正常水平,A组酶学水平进行性升高。于缺血再灌注期间,B、C组组织结构改变较A组明显为轻。结论 供肝糖原水平高,其在缺血—再灌注期间肝功能损伤及肝组织结构损伤则较轻。能量物质的缺乏可能是造成禁食后供肝在冷保存——再灌注期间受损加重的重要原因。Objective To explore the value and the change of energy state of donor liver during ischemia-reperfusion period.Methods Donor group rabbits were divided into three subgroups: A(n = 7)fasting for 24 hours before harvesting; B(n = 7)normallaboratory chew; C(n = 7) normal feeding plus glucose supplement. The level of glycogen, enzymes, ATP and EC (energy change)were measured while the histological changes of donor liver tissue were observed with the help of self-created animal model forstudying ischemia-reperfusion injury. Results After 6-hour cold preservation, the level of glycogen, ATP and EC decreased signifi-cantly. At the end of rewarming period, these data decreased to the lowest point wherease these data recovered to a certain extent ingroup B and C after 2-hour reperfusion. The level of enzymes and the histological changes of donor liver tissue indicated that liversof group A suffered from a more severe injury during ischemia-reperfusion preiod. Conclusion The level of glycogen in donor liverbefore it harvested is closely related to the level of energy state in ischemia-reperfusion period. Those donor livers with high level ofglycogen can maintain a good liver function and have a mild histological changes during ischemia-reperfusion period. Lack of energysubstances in fasting donor liver maybe an important factor for deteriorating its injury.

关 键 词：供肝 肝移植 肝缺血 再灌注 能量代谢 临床意义 

分 类 号：R657.3[医药卫生—外科学]