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心房利钠肽减轻家兔肝脏缺血再灌注损伤。

Atrial natriuretic peptide reduces hepatic ischemia-reperfusion injury in rabbits.

作者信息

Yamada Takashige, Kotake Yoshifumi, Nagata Hiromasa, Takeda Junzo

机构信息

Department of Anesthesiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan,

出版信息

J Anesth. 2013 Dec;27(6):901-8. doi: 10.1007/s00540-013-1643-3. Epub 2013 Jun 5.

Abstract

PURPOSE

Atrial natriuretic peptide (ANP) has been known to be protective against hepatic ischemia/reperfusion injury. The purpose of this study was to verify the hypothesis that ANP conserves microvascular circulation and reduces ischemia-reperfusion injury in the in vivo rabbit model.

METHODS

With IRB approval, 30 male Japanese white rabbits under pentobarbital anesthesia were studied. These animals were randomly assigned to the following three groups (n = 10 each): control, ANP, and sham group. Animals in the ANP group received continuous infusion of ANP at 0.1 μg/kg/min throughout the study period. Animals in control and ANP groups underwent 90 min of partial hepatic ischemia by clamping the right hepatic artery and portal vein. Descending aortic blood flow (AoF) was monitored with a transit-time ultrasound flowmeter. Hepatic tissue microvascular blood flow (HTBF) at both right (ischemic) and left (nonischemic) lobe was intermittently evaluated with the hydrogen clearance method. After 180 min of reperfusion, hepatic injury was determined with serum AST and ALT. Galactose clearance of reperfused right lobe was also measured as an indicator of hepatic metabolic function. Histopathological change and the number of apoptotic hepatocytes were also evaluated.

RESULTS

Systemic hemodynamic data including mean arterial pressure, heart rate, and AoF did not differ among the three groups during the study period. ANP attenuated ischemia-induced right HTBF decrease. ANP also suppressed histopathological degeneration, apoptosis, and decline in galactose clearance after reperfusion.

CONCLUSIONS

ANP attenuated hepatic microvascular dysfunction and hepatocyte injury after reperfusion without significant hemodynamic change.

摘要

目的

已知心房利钠肽(ANP)对肝缺血/再灌注损伤具有保护作用。本研究的目的是验证ANP在体内兔模型中可保护微血管循环并减少缺血再灌注损伤这一假说。

方法

经机构审查委员会(IRB)批准,对30只戊巴比妥麻醉下的雄性日本白兔进行研究。这些动物被随机分为以下三组(每组n = 10):对照组、ANP组和假手术组。ANP组动物在整个研究期间以0.1μg/kg/min的速度持续输注ANP。对照组和ANP组动物通过夹闭右肝动脉和门静脉进行90分钟的部分肝缺血。用渡越时间超声流量计监测降主动脉血流(AoF)。用氢清除法间歇性评估右叶(缺血)和左叶(非缺血)的肝组织微血管血流(HTBF)。再灌注180分钟后,用血清AST和ALT测定肝损伤情况。还测量再灌注右叶的半乳糖清除率作为肝代谢功能的指标。同时评估组织病理学变化和凋亡肝细胞数量。

结果

在研究期间,包括平均动脉压、心率和AoF在内的全身血流动力学数据在三组之间无差异。ANP减轻了缺血诱导的右叶HTBF降低。ANP还抑制了再灌注后的组织病理学退变、细胞凋亡以及半乳糖清除率的下降。

结论

ANP减轻了再灌注后肝微血管功能障碍和肝细胞损伤,且无明显血流动力学变化。

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