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[门静脉淤血对兔肝缺血再灌注所致肺和肾损伤的影响]

[The effect of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion in a rabbit model].

作者信息

Wang Ye, Yang Jia-mei, Hou Yuan-kai, Li Dian-qi, Hu Ming-hua, Liu Peng

机构信息

Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Apr 15;46(8):602-5.

Abstract

OBJECTIVE

To investigate the effect and mechanism of portal blood stasis on lung and renal injury induced by hepatic ischemia reperfusion.

METHODS

A rabbit hepatic ischemia reperfusion injury model was established by hepatic portal occlusion and in situ hypothermic irrigation for 30 min. Twenty-four New Zealand white rabbits were employed and randomly divided into 3 groups equally by different dosage of portal blood stasis removal: group A5 (5 ml blood removal), group A10 (10 ml blood removal),and group B (no blood removal). Eight rabbits were served as controls with no hepatic portal occlusion and hypothermic irrigation. After reperfusion 4 h serum endotoxin content, tumor necrosis factor-alpha (TNF-alpha), urea nitrogen (BUN), and creatinine (Cr) were examined respectively, meantime lung and kidney tissues were sampled to determine the content of malondialdehyde (MDA), superoxide dismutase (SOD), the pathology, and wet to dry weight ratio, broncho-alveolar lavage fluid protein content in lung tissues.

RESULTS

Removing portal blood stasis ameliorated lung and renal injury as shown by decreasing the level of serum endotoxin, TNF-alpha, BUN, Cr, wet to dry weight ratio, broncho-alveolar lavage fluid protein content, MDA, SOD. TNF-alpha, Cr, broncho-alveolar lavage fluid protein content in lung tissues and MDA in kidney tissue in group A5 were significantly reduced compared with those in group B (P < 0.05), while in lung tissue in group A10 were also markedly reduced (P < 0.05). The activation of SOD in group A5 were significantly increased (P < 0.05).

CONCLUSIONS

Removal of portal blood stasis before the resume of splanchnic circulation may ameliorate the lung and renal injury induced by hepatic ischemia reperfusion. The possible mechanism may be that portal blood stasis removal reduces endotoxin absorption, and further decreases production of serum TNF-alpha.

摘要

目的

探讨门静脉淤血对肝缺血再灌注所致肺和肾损伤的影响及机制。

方法

采用门静脉阻断原位低温灌注30分钟建立兔肝缺血再灌注损伤模型。选用24只新西兰白兔,按不同的门静脉淤血清除剂量随机均分为3组:A5组(清除5ml血液)、A10组(清除10ml血液)和B组(未清除血液)。8只兔作为对照组,不进行门静脉阻断和低温灌注。再灌注4小时后分别检测血清内毒素含量、肿瘤坏死因子-α(TNF-α)、尿素氮(BUN)和肌酐(Cr),同时取肺和肾组织测定丙二醛(MDA)、超氧化物歧化酶(SOD)含量、病理变化及肺组织湿干重比、支气管肺泡灌洗液蛋白含量。

结果

清除门静脉淤血可改善肺和肾损伤,表现为血清内毒素、TNF-α、BUN、Cr水平降低,湿干重比、支气管肺泡灌洗液蛋白含量、MDA、SOD降低。A5组肺组织中TNF-α、Cr、支气管肺泡灌洗液蛋白含量及肾组织中MDA与B组比较显著降低(P<0.05),A10组肺组织中上述指标也明显降低(P<0.05)。A5组SOD活性显著升高(P<0.05)。

结论

在内脏循环恢复前清除门静脉淤血可改善肝缺血再灌注所致的肺和肾损伤。可能机制是清除门静脉淤血减少内毒素吸收,进而降低血清TNF-α的产生。

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