Sato T, Kato T, Kurokawa T, Yasui O, Hiroshi N, Miyazawa H, Asanuma Y, Koyama K
Department of Surgery, Akita University School of Medicine, Japan.
Liver. 2000 Apr;20(2):179-83. doi: 10.1034/j.1600-0676.2000.020002179.x.
AIMS/BACKGROUND: Hepatic artery interruption (HAI) causes severe ischemic liver damage, especially following hepatopancreatobiliary surgery. In order to inhibit a decrease in oxygen delivery after HAI, continuous infusion of PGE1 via the superior mesenteric artery (SMA) was administered in pigs and changes in hepatic blood flow and oxygen delivery were investigated. Furthermore, its effectiveness in the prevention of liver injury was evaluated by histology and serum enzyme levels.
Animals were subjected to HAI without PGE1 infusion (control group n=6) and to continuous infusion of PGE1 (0.02 microg/kg/min) into the SMA (PGE1 group n=6).
PGE1 infusion via the SMA not only increased the portal blood flow but also elevated the oxygen content of the portal blood. The reduction in oxygen delivery to the liver was 50% in the control group, and only 13% in the PGE1 group. Serum aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels 24 h after HAI in the control group were 3415+/-1283 IU/L and 9839+/-2959 respectively while in the PGE1 group they were 939+/-426 IU/L and 5510+/-1545 IU/L respectively. Histological examination showed massive necrosis in the control group at 72 h but only focal liver cell necrosis in the PGE1 group. Based on this finding and the fact that this treatment can be performed easily and safely, continuous infusion of PGE1 via the SMA may be a useful intervention to prevent severe liver damage after hepatic artery interruption.
目的/背景：肝动脉阻断（HAI）会导致严重的缺血性肝损伤，尤其是在肝胰胆手术后。为了抑制HAI后氧输送的减少，对猪通过肠系膜上动脉（SMA）持续输注前列腺素E1（PGE1），并研究肝血流和氧输送的变化。此外，通过组织学和血清酶水平评估其预防肝损伤的有效性。
动物分为未输注PGE1的HAI组（对照组，n = 6）和通过SMA持续输注PGE1（0.02μg/kg/min）的组（PGE1组，n = 6）。
通过SMA输注PGE1不仅增加了门静脉血流，还提高了门静脉血的氧含量。对照组肝脏氧输送减少了50%，而PGE1组仅减少了13%。HAI后24小时，对照组血清天冬氨酸转氨酶（AST）和乳酸脱氢酶（LDH）水平分别为3415±1283 IU/L和9839±2959 IU/L，而PGE1组分别为939±426 IU/L和5510±1545 IU/L。组织学检查显示，对照组在72小时出现大片坏死，而PGE1组仅出现局灶性肝细胞坏死。基于这一发现以及该治疗方法可轻松安全实施的事实，通过SMA持续输注PGE1可能是预防肝动脉阻断后严重肝损伤的一种有用干预措施。
