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目的:观察银杏内酯对大鼠自体原位肝移植缺血再灌注损伤的影响,探讨其对大鼠移植肝缺血再灌注损伤的保护作用。方法:通过银杏内酯在门静脉-左肾静脉搭桥、肝后下腔静脉内置管分流法建立的大鼠自体原位肝移植模型上的应用,采用硝酸酶还原法测定肝脏缺血前和再灌注后5min、30min、2h血清血管活性递质一氧化氮(NO)和血浆内皮素(ET1)的水平变化;测定血清谷丙氨基转移酶(ALT)、谷草氨基转移酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)的酶学差异和肝组织三磷酸腺苷(ATP)及丙二醛(MDA)的含量变化;再灌注2h取肝组织,用甲醛固定制成电镜标本,观察肝细胞、肝小叶超微结构。结果:银杏内酯能提高再灌注后血NO水平,并对ALT、AST、LDH的病理性升高有降低作用,且能改善肝脏缺血再灌注损伤的微循环,减轻肝细胞内超微结构的损害程度。结论:肝移植术前施行门腔分流是预防术后发生肝缺血再灌注损伤的有效措施;NO/ET1平衡可能是影响移植肝脏微循环血流量变化的调节因素。银杏内酯对大鼠肝缺血再灌注损伤有保护作用。
OBJECTIVE: To observe the effect of ginkgolide on ischemia-reperfusion injury in autologous orthotopic liver transplantation in rats and to explore its protective effect on hepatic ischemia-reperfusion injury in rats. METHODS: The application of ginkgolides in rat autologous orthotopic liver transplantation model established by portal vein-left renal vein bypass graft and retrohepatic inferior vena cava internal shunt was performed. Nitric enzyme reduction method was used to measure hepatic ischemia before and after reperfusion. Serum levels of serum vasoactive neurotransmitters, nitric oxide (NO) and plasma endothelin (ET1), were measured after 5 min, 30 min, and 2 h; serum ALT, AST, and alkaline phosphatase were measured. The enzymatic difference of enzyme (ALP) and lactate dehydrogenase (LDH) and the changes of hepatic tissue adenosine triphosphate (ATP) and malondialdehyde (MDA) content; liver tissue was taken after reperfusion for 2 hours and fixed with formaldehyde to make electron microscope specimens. Liver cells, liver ultrastructure. RESULTS: Ginkgolide can increase the level of NO in reperfusion and reduce the pathological increase of ALT, AST, and LDH. It can also improve the microcirculation of hepatic ischemia-reperfusion injury and reduce the ultrastructure of liver cells. The degree of damage. Conclusions: Preoperative portal dilation is an effective measure to prevent hepatic ischemia-reperfusion injury after liver transplantation; NO/ET1 balance may be a regulatory factor influencing the microcirculatory blood flow changes in transplanted liver. Ginkgolide has a protective effect on hepatic ischemia-reperfusion injury in rats.