脾脏缺血预处理对大鼠肝脏缺血再灌注损伤的保护作用.pdf

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1、·2580·中华实验外科杂志2o13年12月第30卷第l2期ChinJExpSurg，December2013，Vo1．30，No．12·实验研究·脾脏缺血预处理对大鼠肝脏缺血再灌注损伤的保护作用申东方刘超庞志刚黄涛尚闯何艳新【摘要】目的探讨远程缺血预处理(RIPC)对肝缺血再灌注损伤(HIRI)的影响及其机制。方法将36只雄性sD大鼠随机分为3组：假手术组(Sham组)仅行开腹及肝门分离；缺血再灌注模型组(IR组)采用Pringle’S法阻断肝门15min，再灌注2h；缺血预处理组(RIPC组)首先

2、阻断脾动脉15min，放开15min，后其操作同IR组。各组大鼠在再灌注2h后分别取门静脉血清测谷丙转氨酶(ALT)、谷草转氨酶(AST)；取肝组织作病理学检查、免疫组织化学法肿瘤坏死因子．(TNF一0／．)和P一选择素测定。结果与Sham组比较，血清A、AST水平在IR组[(466，75±89．45)、(782．25-4-87．71)U／L)]和RIPC组[(231．87±50．80)、(326．75±19．12)U／L]明显升高(P<0．05)；肝组织病理损伤评分升高(P<0．05)；肝组织内TN

3、F一和P-选择素表达升高(P<0．05)。其中上述指标在RIPC组中水平较IR组均明显降低(P<0．05)。结论脾脏缺血预处理可减轻HIRI，分析其原因可能是通过减少黏附因子的表达，减轻中性粒细胞的聚集，从而减少炎性损伤而发挥作用。【关键词】缺血预处理；缺血再灌注损伤；肝脏；脾脏RemoteischemicpreconditioningofspleendecreaseshepaticischemiareperfusioninjuryinratsSHENDong，LIUChao，PANGZhi—gang

4、，HUANGTao，SHANGChuang，HEYah—xin．Department0厂AbdominalSurgery，theSecondAffiliatedHospitalofZhengzhouUniversity，Zhengzhou450014．C^inaCorrespondingauthor：LiuChao，Email：drliuchao@sohu．corn【Abstract】ObjectiveToinvestigatetheeffectandmechanismofremoteischemic

5、preconditioningonhepaticischemia—reperfusioninjury．MethodsThirtysixSDratsweredividedintothreegrouprandom-ly：Sham—operatedgroup(Shamgroup)，ischemia—reperfusiongroup(IRgroup：producedbytotalinflowocclusionfor15min)，andremoteischemicpreconditioninggroup[rem

6、oteischemicpreconditioning(RIPC)group：inducedwith15minischemiaofspleenbeforehepaticischemia]．Serumaminotransferases[alanineaminotransferase(ALT)，aspartateaminotransferase(AST)]andtumornecrosisfactor(TNF)一0I，P—selectininliverweremeasuredafterreperfusionf

7、or2h．ResultsComparedwiththeShamgroup，thelevelofAIJT，ASTandthepathologicalinjuryscoresweresignificantlyincreasedintheIR[(466．75±89．45)，(782．25±87．71)U／LandRIPC(231．87±50．80)，(326．75±19．12)u／L]groups．TNF一0landp-selectinexpressionwerehighwhenIRonlyaswel1．T

8、hesevariablesweresignificantdecreasedinRIPCgroup．ConclusionRemoteischemicpreconditioningofspleendecreasesthereperfusioninjurydur—inghepaticischemiawhichmaybecausedbythedecreaseofpro—ilflammatoryandactivityofneutophils．【Keywords】R