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论著:二氮嗪预处理对大鼠部分肝移植的保护作用
Protective Effect of Diazoxide Preconditioning in Partial Liver Transplantation in Rats
宋康 孙绮蛮 周俭 黄晓武 史颖弘 肖永胜 谭长军 高强 何义舟 成剑文 杨柳晓 樊嘉
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作者单位:复旦大学附属中山医院肝外科
中文关键字:部分肝移植;二氮嗪;预处理;缺血再灌注损伤;大鼠
英文关键字:Partial liver transplantation; Diazoxide; Preconditioning; Ischemia reperfusion injury; Rat
中文摘要:目的:探讨二氮嗪(diazoxide, DA)预处理对大鼠部分肝移植的保护作用,寻找减轻临床部分肝移植中缺血再灌注损伤的途径。方法:将150只SD(Sprague Dawley)大鼠,随机配对成75对,分为3组:对照组(C组)、DA预处理组(DA组)和5 羟基癸酸盐(5 hydroxydecanoate sodium salt, 5 HD)+DA预处理组(HD DA组),每组25对。在进行60%比例部分肝移植术前,C组供体不进行药物预处理;DA组供体在术前30 min腹腔注射DA(5 mg/kg);HD DA组供体在术前45 min腹腔注射5 HD(5 mg/kg),并在其后15 min腹腔注射DA(5 mg/kg)。各组分别在术后2 h、1 d、3 d、5 d和7 d各处死5只受体大鼠,测定谷酸丙氨酸转移酶(alanine aminotransferase, ALT)和门冬氨酸氨基转移酶(aspartate aminotransferase, AST),并在光镜下进行病理检查,电镜下进行超微结构检查。结果:DA组与C组相比,肝细胞肿胀、变性、坏死和空泡样变性以及肝小叶结构排列紊乱和汇管区炎症都较轻,而HD DA组则跟与C组相近。 DA组术后2 h、1 d、3 d的ALT值和AST值均显著低于C组 (P<0.05),而HD DA组与C组相比,各时点ALT和AST值均无显著差异(P>0.05)。结论:二氮嗪预处理对大鼠部分肝移植具有保护作用,但这种保护作用可以被5 羟基癸酸盐特异性阻断。
英文摘要:Objective: To investigate the protective effect of diazoxide preconditioning in partial liver transplantation in rats. Methods:Seventy five pairs of Sprague Dawley rats were randomly divided into 3 groups and each group consisted of 25 pairs. Rats in all the 3 groups underwent partial liver transplantation. Donor rats in one group (Group DA) were treated by intrape ritoneal injection of diazoxide (5 mg / kg) 30 min before the operation; donor rats in another group (Group HD DA) were treated by intraperitoneal injection of 5 hydroxydecanoate (5 mg / kg) 45 min before the operation and intraperitoneal injection of diazoxide (5 mg / kg) 30 min before the operation; donor rats in the other group (Group C) underwent no drug pretreatment. Five recipients in each group were killed at 2 h, 1 d, 3 d, 5 d, and 7 d postoperatively. The levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were detected. Pathological examination was done by light microscope and electro microscope. Results: As compared with Group C, the liver cells of Group DA showed less swelling and necrosis; the structure of hepatic lobule of Group DA was less disorderly; and the inflammation in Group DA was less serious. The levels of ALT and AST at 2 h, 1 d, and 3 d post operatively in Group DA were significantly lower than those in Group C and Group HD DA (P<0.05). Conclusions: Diazoxide preconditioning have protective effect in partial liver transplantation in rats, but it can be specially blocked by 5 HD.
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