Eleftheriadis E, Kotzampassi K, Iliadis S, Milias K, Papageorgiou G, Dimitriadou A, Katsohis K
Department of Surgery, University of Thessaloniki Medical School, Greece.
Hepatogastroenterology. 1997 Jul-Aug;44(16):1187-92.
BACKGROUND/AIMS: The hemodynamic disturbances in the cirrhotic liver following severe variceal bleeding and subsequent restoration by blood transfusion is an ischemia/reperfusion injury event which represents the clinical situation of liver dysfunction. Therefore, the aim of this study was to evaluate the microcirculation, oxygenation and energy charge of the cirrhotic rat liver after ischemia/reperfusion.
In eight carbon tetrachloride-induced cirrhotic rats and an equal number of controls subjected to 30 minutes of ischemia and 60 minutes of reperfusion by hepatoduodenal ligament clamping, the following parameters were assessed: hepatic microcirculation by laser-Doppler fluxmetry, hepatic tissue oxygenation by a Clark-type electrode, hepatic energy charge by tissue sampling and adenine-nucleotides determination by means of high-performance liquid chromatography.
At baseline, liver microcirculation was found to be significantly decreased in the cirrhotics versus controls groups. Ischemia led to a reduction in both groups, while reperfusion improved microcirculation, but not to the baseline level. Oxygenation was reduced during ischemia and restored after reperfusion in both groups. Hepatic energy charge was reduced in the cirrhotics versus controls at baseline, and significantly decreased during ischemia in both groups. At reperfusion, a further reduction was found in the cirrhotic group, while in the control group it was restored to baseline.
Hepatic microcirculation, oxygenation and energy charge are subjected to different degrees of diminution after ischemia/reperfusion in the cirrhotic rat liver.
背景/目的:严重静脉曲张破裂出血后肝硬化肝脏的血流动力学紊乱以及随后输血恢复过程是一种缺血/再灌注损伤事件,代表了肝功能障碍的临床情况。因此,本研究的目的是评估缺血/再灌注后肝硬化大鼠肝脏的微循环、氧合和能量状态。
对8只四氯化碳诱导的肝硬化大鼠和同样数量的对照大鼠通过夹闭肝十二指肠韧带进行30分钟缺血和60分钟再灌注,评估以下参数:用激光多普勒血流仪测量肝脏微循环,用Clark型电极测量肝组织氧合,通过组织取样和高效液相色谱法测定腺嘌呤核苷酸来评估肝脏能量状态。
在基线时,发现肝硬化组的肝脏微循环与对照组相比显著降低。缺血导致两组均降低,而再灌注改善了微循环,但未恢复到基线水平。两组在缺血期间氧合均降低,再灌注后恢复。肝硬化组与对照组相比,基线时肝脏能量状态降低,两组在缺血期间均显著降低。在再灌注时,肝硬化组进一步降低,而对照组恢复到基线水平。
肝硬化大鼠肝脏缺血/再灌注后,肝脏微循环、氧合和能量状态受到不同程度的损害。