高氧液联合缺血后处理对家兔肠缺血再灌注致肝损伤的保护作用

发布时间：2018-07-17 21:54

【摘要】：目的探讨高氧液联合缺血后处理对家兔肠缺血再灌注所致肝损伤的保护作用。方法将家兔48只随机分为假手术组(SO组)、缺血再灌注组(IR组)、高氧液组(HO组)和高氧液缺血后处理组(HI组),每组12只。SO组家兔仅手术显露肠系膜上动脉(SMA);IR组家兔阻断SMA 60 min,再灌注120 min;HO组家兔在阻断SMA 60 min和再灌注120 min过程中静脉输入高氧液;HI组家兔于阻断SMA 60 min后,再灌注开始时静脉输入高氧液,同时进行3个循环的30 s再灌注/30 s阻断的缺血后处理。再灌注120 min后采集各组家兔动脉血、静脉血及部分小肠、肝组织,检测肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-10、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及内毒素水平,测定血清及小肠、肝组织内丙二醛(MDA)含量及髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)活性,Chiu 6级评分法观察肠黏膜损伤情况,细菌培养观察细菌移位率,免疫组织化学观察肝组织中核因子κB(NF-κB)p65的表达。结果 IR组家兔血清中TNF-α、IL-10、内毒素水平显著高于SO组(P0.01);HO组和HI组家兔血清中TNF-α、内毒素水平显著低于IR组(P0.05);HI组家兔血清中TNF-α、内毒素水平显著低于HO组(P0.05,P0.01)。HO组和HI组家兔血清中IL-10水平显著高于IR组(P0.01),HO组和HI组家兔血清中IL-10水平比较差异无统计学意义(P0.05)。IR组家兔血清中MPO活性和MDA水平显著高于SO组(P0.01),HO组和HI组家兔血清中MPO活性和MDA水平显著低于IR组(P0.01);HI组家兔血清中MPO活性和MDA水平显著低于HO组(P0.05,P0.01)。IR组家兔血清中SOD活性显著低于SO组(P0.01),HO组和HI组家兔血清中SOD活性显著高于IR组(P0.01),且HI组家兔血清中SOD活性显著高于HO组(P0.01)。IR组、HO组和HI组家兔肠黏膜损伤评分显著高于SO组(P0.01),HO组和HI组家兔肠黏膜损伤评分显著低于IR组(P0.01),HI组家兔肠黏膜损伤评分显著低于HO组(P0.05)。IR组家兔小肠黏膜组织中MPO活性和MDA水平显著高于SO组(P0.01);HO组和HI组家兔小肠黏膜组织中MPO活性和MDA水平显著低于IR组(P0.01);HI组家兔小肠黏膜组织中MPO活性和MDA水平显著低于HO组(P0.05)。IR组家兔小肠黏膜组织中SOD活性显著低于SO组(P0.01);HO组、HI组血清SOD活性仍显著高于IR组(P0.01);HI组家兔小肠黏膜组织中SOD活性显著高于HO组(P0.05)。SO组家兔肝组织均无细菌移位,IR组家兔肝脏细菌移位率100.0%,HO和HI组家兔肝脏细菌移位率均为83.3%,HO和HI组家兔肝脏细菌移位率与IR组比较差异均无统计学意义(P0.05)。IR组、HO组、HI组家兔肝组织内NF-κB p65阳性表达显著高于SO组(P0.01),HO组和HI组家兔肝组织内NF-κB p65阳性表达显著低于IR组(P0.01),HI组家兔肝组织内NF-κB p65阳性表达显著低于HO组(P0.05)。IR组家兔肝组织中MPO活性及MDA、ALT、AST水平显著高于SO组(P0.01);HO组和HI组家兔肝组织中MPO活性及MDA、ALT、AST水平仍显著低于IR组(P0.01);HI组家兔肝组织中MPO活性及MDA、ALT、AST水平显著低于HO组(P0.05)。IR组家兔肝组织中SOD活性显著低于SO组(P0.01),HO组和HI组家兔肝组织中SOD活性显著高于IR组(P0.01);HI组家兔肝组织中SOD活性显著高于HO组(P0.05)。结论高氧液联合缺血后处理可以减轻肠缺血再灌注引起的肝损伤。
[Abstract]:Objective To investigate the protective effects of high oxygen liquid combined with ischemic posttreatment on hepatic injury induced by ischemia - reperfusion in rabbits . Methods 48 rabbits were randomly divided into sham operation group ( SO group ) , ischemia / reperfusion group ( IR group ) , high oxygen liquid group ( HO group ) and high oxygen liquid ischemic posttreatment group ( HI group ) . The levels of MPO and MDA in the serum of the HO group and HI group were significantly higher than those in the IR group ( P0.01 ) . The MPO activity and MDA level in the serum of the IR group were significantly higher than those in the IR group ( P0.01 ) . The MPO activity and MDA level in the serum of the HI group were significantly lower than those in the HO group ( P0.05 , P0.01 ) . The activities of MPO and MDA , ALT and AST in the liver tissues of the rabbits were significantly lower than those in the IR group ( P0.01 ) . The levels of MPO and MDA , ALT and AST in the liver tissues of the HI group were significantly lower than those in the IR group ( P0.01 ) .
【作者单位】：新乡医学院第一附属医院普通外科;
【基金】：河南省卫生厅科技攻关项目(编号:201203071) 河南省教育厅自然科学项目(编号:2012b320019,2011a32001,14A320075)
【分类号】：R363

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