【摘要】：目的觀察缺血后預(yù)處理對缺血再灌注大鼠肝內(nèi)膽管細(xì)胞損傷的影響并探討其機制。方法取健康雄性SD大鼠24只,隨機分為假手術(shù)組、缺血再灌注組、缺血后處理組,每組8只。假手術(shù)組:大鼠麻醉后于上腹部正中取一長3.5 cm縱切口,將腹壁各層依次切開,肝臟顯露后進(jìn)一步游離出肝十二指腸韌帶,關(guān)腹,無其他干預(yù)。缺血再灌注組:在假手術(shù)組基礎(chǔ)上,游離肝十二指腸韌帶,用無損傷動脈夾將肝門區(qū)域夾閉,缺血30 min后取下血管夾,使血管開放,對肝臟持續(xù)再灌注,最后關(guān)腹。缺血后處理組:在缺血再灌注組基礎(chǔ)上,血供完全恢復(fù)之前再灌注10 s,夾閉10 s,如此反復(fù)6個循環(huán)(共2 min)后完全恢復(fù)血供。比色法測定血清γ-GT、SOD活力,免疫組化法測定膽管組織中Bcl-2和Bax蛋白表達(dá),采用原位缺口末端標(biāo)記法測算膽管細(xì)胞凋亡指數(shù)(AI),HE染色后光鏡下觀察膽管上皮細(xì)胞基本形態(tài)學(xué)變化。結(jié)果 IR組、IPO組、SO組血清γ-GT值分別為(34.64±3.28)、(26.30±3.32)、(17.33±2.08)U/L,三組間兩兩比較,P均0.05。SO組、IR組、IPO組大鼠血清SOD活力值分別為(58.26±3.00)、(60.28±3.73)、(61.53±7.99)U/m L,各組間比較,P均0.05。IR組、IPO組、SO組膽管組織中Bcl-2蛋白陽性表達(dá)率分別為(42.67±3.73)%、(77.94±5.25)%、(18.21±4.16)%,三組間兩兩比較,P均0.05。IR組、IPO組、SO組膽管組織中Bax蛋白陽性表達(dá)率分別為(90.17±2.12)%、(70.10±4.27)%、(30.63±3.00)%,三組間兩兩比較,P均0.05。IR組、SO組、IPO組AI分別為79.31±1.12、26.06±2.27、58.90±2.75,三組間兩兩比較,P均0.05。IPO組病理改變較IR組明顯減輕,肝小葉結(jié)構(gòu)較完整,肝細(xì)胞變性程度減輕,匯管區(qū)膽管上皮連續(xù)完整,炎細(xì)胞浸潤少。結(jié)論缺血后預(yù)處理通過促進(jìn)肝內(nèi)膽管組織中Bcl-2蛋白表達(dá)、抑制Bax蛋白表達(dá),抑制SD大鼠肝臟缺血再灌注過程中肝內(nèi)膽管細(xì)胞凋亡,從而減輕肝臟缺血再灌注過程中肝內(nèi)膽管細(xì)胞的損傷。
[Abstract]:Objective To observe the effect of pre-ischemic preconditioning on the hepatic bile duct cell injury in rats with ischemia-reperfusion and to explore its mechanism. Methods 24 healthy male SD rats were randomly divided into the sham operation group, the ischemia-reperfusion group and the ischemic post-treatment group. Sham operation group: after the rats were anesthetized, a long 3.5 cm longitudinal incision was taken in the middle of the upper abdomen, the layers of the abdominal wall were cut in sequence, and the hepatic and duodenal ligament was further free after the liver was exposed, and the abdomen was closed without any other intervention. Ischemia-reperfusion group: on the basis of the sham-operation group, the free-hepatic duodenal ligament was closed, the area of the liver-door was clipped by the non-invasive valve clamp, and the lower blood vessel clamp was taken after the ischemia for 30 min, so that the blood vessel was opened, the liver was continuously reperfused, and the abdomen was finally closed. Post-ischemic post-treatment group: on the basis of the ischemia-reperfusion group, the blood supply was reperfused for 10 s before the blood supply was fully recovered, and the blood supply was completely recovered after repeated 6 cycles (2 min). The expression of Bcl-2 and Bax in the bile duct was determined by colorimetric method, and the expression of Bcl-2 and Bax in the bile duct tissue was determined by immunohistochemistry. The apoptosis index (AI) of the bile duct was measured by the in-situ nick end labeling method. The basic morphological changes of the bile duct epithelial cells were observed under the light microscope after HE staining. Results The serum SOD-GT values of the IR group, the IPO group and the SO group were (34.64-3.28), (26.30-3.32), (17.33-2.08) U/ L, and the serum SOD activity values of the group were (58.26-3.00), (60.28-3.73), (61.53-7.99) U/ m-L, respectively. The positive rate of Bcl-2 protein in the group was 42.67 (3.73)%, (77.94-5.25)%, (18.21-4.16)%, and P was 0.05. IR group and IPO group, respectively. The positive expression rate of Bax in the bile duct of the SO group was (90.17-2.12)%, (70.10-4.27)%, (30.63-3.00)%, and between the three groups, P was 0.05. IR group, SO group and IPO group AI were 79.31-1.12, 26.06-2.27, 58.90-2.75 respectively. P was 0.05. The pathological changes of the IPO group were significantly reduced in the IR group, the structure of the hepatic lobule was relatively complete, the degree of degeneration of the liver cells was reduced, the epithelium of the bile duct of the foreign exchange tube was continuous and intact, and the infiltration of the inflammatory cells was less. Conclusion The post-ischemic preconditioning can inhibit the expression of Bcl-2 protein in the hepatic bile duct tissue, inhibit the expression of Bax protein, and inhibit the apoptosis of the intrahepatic bile duct cells in the hepatic ischemia-reperfusion process of the SD rats, thereby reducing the damage of the hepatic bile duct cells in the hepatic ischemia-reperfusion process.
【作者單位】： 河北省人民醫(yī)院;
【分類號】：R575

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