Yoshizumi T, Yanaga K, Soejima Y, Maeda T, Uchiyama H, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Br J Surg. 1998 Dec;85(12):1636-40. doi: 10.1046/j.1365-2168.1998.00917.x.
Ischaemic preconditioning, i.e. preparatory brief ischaemia before subsequent long ischaemia, can effectively protect the heart from ischaemia-reperfusion injury in animals. The purpose of this study was to demonstrate the same phenomenon in the liver.
Using warm ischaemia-reperfusion of 70 per cent of the liver followed by resection of the non-ischaemic portion in rats, livers with 10 min of ischaemic preconditioning, i.e. 10 min of warm ischaemia and reperfusion, were compared with those that had not been subjected to such a manoeuvre.
At 120 min after reperfusion following 40 min of warm ischaemia, the livers with 10 min of ischaemic preconditioning had a significantly lower mean(s.d.) serum alanine aminotransferase level (492(217) versus 1236(695) units/l; P < 0005) and lactic dehydrogenase level (7905(4002) versus 15066(9201) units/l; P< 0.05), as well as a higher bile output (0.12(0.03) versus 0.09(0.04) ml per g liver; P < 0.05) and liver tissue adenosine 5'-triphosphate level (78(13) versus 61(11) per cent; P< 0.05) than the control livers. The necrosis rate, histologically defined as the percentage of necrotic area in given liver sections, was reduced significantly by this manoeuvre (mean(s.d.) 1.3(1.3) versus 5.3(1.7) per cent; P< 0.05).
Ischaemic preconditioning exerts a protective effect on hepatic warm ischaemia-reperfusion injury. Such a manoeuvre may be useful for hepatic resection in the clinical setting.
缺血预处理，即在随后的长时间缺血之前进行短暂的缺血预处理，可有效保护动物心脏免受缺血再灌注损伤。本研究的目的是在肝脏中证实同样的现象。
采用大鼠肝脏70%的温缺血再灌注，随后切除非缺血部分，将经历10分钟缺血预处理（即10分钟温缺血和再灌注）的肝脏与未进行该操作的肝脏进行比较。
在40分钟温缺血后的再灌注120分钟时，经历10分钟缺血预处理的肝脏的平均（标准差）血清丙氨酸转氨酶水平显著更低（492（217）对1236（695）单位/升；P<0.005），乳酸脱氢酶水平也更低（7905（4002）对15066（9201）单位/升；P<0.05），胆汁输出更高（0.12（0.03）对0.09（0.04）毫升/克肝脏；P<0.05），肝组织三磷酸腺苷水平更高（78（13）%对61（11）%；P<0.05）。组织学上定义为给定肝脏切片坏死面积百分比的坏死率通过该操作显著降低（平均（标准差）1.3（1.3）%对5.3（1.7）%；P<0.05）。
缺血预处理对肝脏温缺血再灌注损伤具有保护作用。这种操作在临床环境中可能对肝切除术有用。
