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去铁胺减轻肝脏血管控制下大肝切除术后的胰腺损伤:猪的实验研究

Desferrioxamine Attenuates Pancreatic Injury after Major Hepatectomy under Vascular Control of the Liver: Experimental Study in Pigs.

作者信息

Varsos Panagiotis, Nastos Constantinos, Papoutsidakis Nikolaos, Kalimeris Konstantinos, Defterevos George, Nomikos Tzortzis, Pafiti Agathi, Fragulidis George, Economou Emmanuel, Kostopanagiotou Georgia, Smyrniotis Vassilios, Arkadopoulos Nikolaos

机构信息

Fourth Department of Surgery, School of Medicine, University of Athens, Attikon University Hospital, 1 Rimini Street, 12462 Athens, Greece.

出版信息

HPB Surg. 2012;2012:714672. doi: 10.1155/2012/714672. Epub 2012 Jun 25.

Abstract

Introduction. Pancreatic injury can manifest after major hepatectomy under vascular control. The main mechanism involved seems to be remote oxidative injury due to "spillage" of reactive oxygen species and cytokines from the liver. The aim of this study is to evaluate the role of desferrioxamine in the prevention of pancreatic injury following major hepatectomy. Methods. Twelve Landrace pigs were subjected to a combination of major hepatectomy (70-75%), using the Pringle maneuver for 150 minutes, after constructing a porta-caval side-to-side anastomosis. The duration of reperfusion was 24 hours. Animals were randomly divided into a control group (n = 6) and a desferrioxamine group (DFX, n = 6). DFX animals were treated with continuous IV infusion of desferrioxamine 100 mg/kg. Pancreatic tissue injury, c-peptide and amylase concentrations, and pancreatic tissue oxidative markers were evaluated. Results. Desferrioxamine-treated animals showed decreased c-peptide levels, decreased acinar cell necrosis, and decreased tissue malondialdehyde levels 24 hours after reperfusion compared with the control group. There was no difference in portal pressure or serum amylase levels between the groups. Conclusions. Desferrioxamine seems to attenuate pancreatic injury after major hepatectomy under vascular control possibly by preventing and reversing production and circulation of oxidative products.

摘要

引言。在血管控制下进行大肝切除术后可能会出现胰腺损伤。所涉及的主要机制似乎是由于肝脏中活性氧和细胞因子的“溢出”导致的远程氧化损伤。本研究的目的是评估去铁胺在预防大肝切除术后胰腺损伤中的作用。方法。12头长白猪在构建门腔侧侧吻合术后,采用Pringle手法进行150分钟的大肝切除术(70 - 75%)。再灌注持续时间为24小时。动物被随机分为对照组(n = 6)和去铁胺组(DFX,n = 6)。DFX组动物通过静脉持续输注100mg/kg去铁胺进行治疗。评估胰腺组织损伤、C肽和淀粉酶浓度以及胰腺组织氧化标志物。结果。与对照组相比,去铁胺治疗的动物在再灌注24小时后C肽水平降低、腺泡细胞坏死减少且组织丙二醛水平降低。两组之间门静脉压力或血清淀粉酶水平无差异。结论。去铁胺似乎可以减轻血管控制下大肝切除术后的胰腺损伤,可能是通过预防和逆转氧化产物的产生和循环来实现的。

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本文引用的文献

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Pancreatic injury after major hepatectomy: a study in a porcine model.大肝切除术后的胰腺损伤:猪模型研究。
Surg Today. 2012 Apr;42(4):368-75. doi: 10.1007/s00595-011-0039-y. Epub 2011 Nov 11.
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