摘要
AIM: To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion. METHODS: Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO), intermittent occlusion for 10 (IO-10), 15(IO-15), 20(IO-20) and 30(IO-30) minutes with 5 minutes of reflow and continuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge (EC). Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed. RESULTS: At 60 minutes after reperfusion following a total of 60 minutes of hepatic inflow occlusion, EC values in IO-10 (0.749 +/- 0.012) and IO-15 (0.699 +/- 0.002) groups were rapidly restored to that in SO group (0.748 +/- 0.016), TTC reduction activities remained in high levels (0.144 +/- 0.002 mg/mg protein, 0.139 +/- 0.003 mg/mg protein and 0.121 +/- 0.003 mg/mg protein in SO, IO-10 and IO-15 groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 +/- 0.023 and 0.534 +/- 0.027) accompanying with a significantly decreased TTC reduction activities (0.070 +/- 0.005 mg/mg protein and 0.061 +/- 0.003 mg/mg protein). No recovery in EC values (0.228 +/- 0.004) and a progressive decrease in TTC reduction activities (0.033 +/- 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD(3)) and POD(7) and of the serum alanine aminotransferase (ALT) on POD(3) in CO-60 group
AIM To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion.``METHODS Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO),intermittent occlusion for 10 (IO-10), 15(IO-15). 20(IO-20)and 30(IO-30) minutes with 5 minutes of refiow andcontinuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge ( EC ).Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed.``RESULTS At 60 minutes after reperfusion following atotal of 60 minutes of hepatic inflow occlusion, EC values in lO-L0 (0.749±:0.012) and IO-15 (0.699 ±0.002) groups were rapidly restored to that in SO group (0. 748± 0.016).TTC reduction activities remained in high levels (0. 144 ±0.002 mg/mg protein, 0. 139 + 0.003 mg/mg protein and 0.121 ± 0.003 mg/mg protein in SO, IO-10 and IO-15groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 ± 0.023 and 0.534 ±0.027) accompanying with a significantly decreased TTCreduction activities (0.070 ± 0.005 mg/mg protein and 0.061 ±0.003 rng/mg protein). No recovery in EC values , i).228 ± 0.004) and a progressive decrease in TTC reduction activities ( 0.03.3 ± 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD3 ) and POD7 and of the serum alanineaminotransferase (ALT) on POD3 in CO-60 group remained higher than th
作者
Dao-Xiong Lei~(1,2) Cheng-Hong Peng~1 Shu-You Peng~1 Xian-Chuan Jiang~1 Yu-Lian Wu~1 Hong-Wei Shen~1 1 Department of Surgery,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,Zhejiang Province,China2 Department of Surgery,Zhongnan Hospital,Wuhan University School of Medicine,Wuhan 430071,Hubei Province,China
基金
This Work was supported by the grant from the Science and Technology Committee of Zhejiang Province,No.971103132
