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下肢缺血再灌注后肝脏损伤的重要性如何?大鼠模型的实验研究。

How important is the damage to the liver after lower limb ischemia-reperfusion? An experimental study in a rat model.

作者信息

Gökalp Gamze, Eygi Bortecin, Kiray Müge, Açıkgöz Burcu, Berksoy Emel, Bıcılıoğlu Yüksel, Zengin Neslihan, İşcan Şahin, Gökalp Orhan, Gürbüz Ali

机构信息

Department of Child Health and Diseases, Division of Pediatric Emergency, Katip Çelebi University Medical Faculty, Izmir, Turkey.

Department of Cardiovascular Surgery, Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan 23;28(1):127-133. doi: 10.5606/tgkdc.dergisi.2020.18631. eCollection 2020 Jan.

Abstract

BACKGROUND

The aim of this study was to compare the effect of lower extremity ischemia reperfusion on the liver and the effect of ischemiareperfusion on the liver itself in a rat model.

METHODS

Thirty Sprague-Dawley male rats were randomly divided into three groups including 10 in each group: sham (Group 1), lower limb ischemia-reperfusion (Group 2), and liver ischemia-reperfusion (Group 3). In Group 2, one hour of left lower limb ischemia was performed. In Group 3, one hour of ischemia in the liver was performed, followed by 24 hours of reperfusion. After reperfusion, the liver tissues were removed, and the groups were evaluated biochemically and histologically.

RESULTS

The liver malondialdehyde levels were significantly higher in Groups 2 and 3 than in the sham group (p<0.001). In Group 2, the malondialdehyde levels were significantly higher than in Group 3 (p=0.019). The glutathione levels in the liver were significantly lower in Groups 2 and 3 than in the sham group (p<0.001). However, the glutathione levels were significantly higher in Group 2 than in Group 3 (p=0.005). In the histological evaluation, although the liver damage score was higher in Group 3 than in Group 2 (p=0.015), there was no significant difference between the two groups in TUNEL(+) cell number (p>0.05).

CONCLUSION

Reperfusion injury in the liver after lower limb ischemiareperfusion is as important as ischemia-reperfusion injury which is specifically induced in the liver. This should be taken into account, particularly in reperfusion surgeries following vascular trauma or in cases of leg tourniquets to stop bleeding after lower limb vascular trauma.

摘要

背景

本研究的目的是在大鼠模型中比较下肢缺血再灌注对肝脏的影响以及肝脏自身缺血再灌注的影响。

方法

30只雄性Sprague-Dawley大鼠随机分为三组,每组10只:假手术组(第1组)、下肢缺血再灌注组(第2组)和肝脏缺血再灌注组(第3组)。第2组进行1小时左下肢缺血。第3组进行1小时肝脏缺血,随后再灌注24小时。再灌注后,取出肝脏组织,对各组进行生化和组织学评估。

结果

第2组和第3组肝脏丙二醛水平显著高于假手术组(p<0.001)。第2组丙二醛水平显著高于第3组(p=0.019)。第2组和第3组肝脏谷胱甘肽水平显著低于假手术组(p<0.001)。然而,第2组谷胱甘肽水平显著高于第3组(p=0.005)。在组织学评估中,虽然第3组肝脏损伤评分高于第2组(p=0.015),但两组TUNEL(+)细胞数量无显著差异(p>0.05)。

结论

下肢缺血再灌注后肝脏的再灌注损伤与肝脏特异性诱导的缺血再灌注损伤同样重要。尤其在血管创伤后的再灌注手术或下肢血管创伤后使用腿部止血带止血的情况下,应考虑到这一点。

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