内皮细胞功能紊乱在肝缺血—再灌注损伤中的作用及左旋精氨酸的干预  

Role of disfunction of endothelial cell in hepatic ischemia-reperfusion injury and effect of L-Arginine

作　　者：王万铁[1] 谢克俭[2] 徐正衸[1] 王卫[1] 林丽娜[3] 

机构地区：[1]温州医学院病理生理学教研室,浙江温州325027 [2]温州医学院检验系分析中心 [3]温州医学院附属一院麻醉科

出　　处：《中国急救医学》2003年第9期596-597,共2页Chinese Journal of Critical Care Medicine

基　　金：浙江省跨世纪学术和技术带头人;温州市"5 5 1人才工程"培养基金;浙江省卫生厅科研基金联合资助项目 (No .992 0 86;980 18;98A0 87)

摘　　要：目的　探讨内皮细胞功能紊乱在肝缺血—再灌注损伤中的作用及左旋精氨酸对其的影响。方法　实验兔和肝癌手术患者均随机分为肝缺血—再灌注组 (n =10和n =6 )和肝缺血—再灌注 +左旋精氨酸治疗组 (n =10和n =6 ) ;分别取缺血前、缺血 4 5min(兔 )或 2 5min(患者 )和再灌注 4 5min(兔 )或 2 5min(患者 )共 3个时相点 ,用放射免疫法测定血浆透明质酸(HA) ,赖氏法检测谷丙转氨酶 (ALT)。结果　肝缺血—再灌注期间 ,实验兔和肝癌手术患者血浆HA、ALT明显升高 ,尤以再灌注 4 5min(兔 )或 2 5min(患者 )为著 (P <0 0 5或P <0 0 1)。左旋精氨酸可逆转上述指标 ,缺血时兔HA和ALT虽降低 ,但均P>0 0 5 ;患者HA虽降低 ,但P >0 0 5 ,而ALTP <0 0 1。再灌注时兔HA和ALT明显降低 ,均P <0 0 1;患者HA和ALT也显著下降 ,均P <0 0 1。结论　内皮细胞功能紊乱在肝缺血—再灌注损伤发生、发展中起重要的作用 ,左旋精氨酸通过保护内皮细胞而减轻肝缺血—再灌注损伤。Objective To study the role of disfunction of endothelial cell during hepatic ischemia-reperfusion injury (HIRI) and effects of L-Arginine(L-Arg).Methods The rabbits and patients who underwent elective hepatic surgery were randomly divided into two groups, HIRI group (A) and HIRI+L-Arg group (B). Plasma hyaluronic acid (HA) and alanine aminotransferase (ALT) were measured before ischemia, at 45 minutes (rabbits) or 25 minutes (patients) after ischemia and at 45 minutes (rabbits) or 25 minutes (patients) after reperfusion. Results Compared with pre-ischemia in rabbits A, HA and ALT increased during ischemia 45 minutes (or 25 minutes) in rabbits and patients, P <0.05 or P <0.01. Treatment with L-Arg could markedly reduce the elevation of mentioned biochemical parameter. During hepatic ischemia, HA and ALT decreased but the differences were not significant ( P >0.05). In patients, HA decreased but the difference was not significant ( P >0.05), ALT decreased ( P <0.01). After reperfusion, HA and ALT all decreased in rabbits and patients (all P <0.01). Conclusion These data suggested that disfunction of endothelial cell played an important role in the happening and development of HIRI. Treatment with L-Arginine might attenuate ischemia-reperfusion injury by protecting endothelial cell. [

关 键 词：缺血-再灌注损伤 肝脏 透明质酸 左旋精氨酸 内皮 

分 类 号：R363[医药卫生—病理学]