摘要
目的建立稳定的兔脑死亡模型，检测脑死亡后不同时间点肝脏形态及功能变化，评估脑死亡者供肝进行移植手术的可行性。方法健康新西兰兔40只，随机分为假手术组（n=20）和脑死亡组（n=20）。各组再根据脑死亡后时间分为2、4、6及8h四个亚组。分别于实验结束后，留取血液及肝脏组织，用全自动生化分析仪检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）水平，HE染色法观察肝脏的形态学改变，原位末端标记法检测肝脏细胞的凋亡情况；并用竞争抑制ELISA法检测血清中白介素（IL）-1β、IL-6、IL8、肿瘤坏死因子（TNF）-α的水平。结果脑死亡后2、4、6及8h血清中ALT与AST均有所升高，且以脑死亡后8h最高，与6h相比，差异有统计学意义（P=0．0021，P=0．0086）。光镜下，脑死亡后2、4h肝脏无明显改变；而在脑死亡后8h，肝细胞变性明显，肝索结构消失，部分肝细胞灶状坏死。该形态学变化与凋亡指数的变化趋势一致。血清IL-1β、IL-6、IL-8、TNF-α水平均随着脑死亡时间延长而增加。结论脑死亡可以导致肝脏功能及形态学改变，且随脑死亡时间的延长其改变更加明显。该现象可能与炎症介质的释放有关。脑死亡状态维持8h以上，肝脏的形态及功能将发生明显改变。
Objective To establish the rabbit brain death model, observe the change of liver function and morphology in the brain death rabbits, and evaluate the possibility of transplantation sur- gery carried out with brain death donor liver. Methods 40 healthy New Zealand rabbits were random- ly divided into sham group （n=20） and brain death group （n^20）, and each group Was further divid- ed into four subgroups according to 2, 4, 6 and 8 h after brain death. At the end of the experiment, the blood samples and liver tissues were collected. The level of alanine transaminase （ALT）, aspartate transaminase （AST） and lihe apoptosis of liver ceils were determined by automatic biochemistry analy- zer and TUNEL method respectively. The morphology changes of liver were detected by HE staining, and the levels of interleukin （[L）-β1, IL-6, IL-8, tumor necrosis factor （TNF）-α were detected by competitive inhibition ELISA. Rtnmlts In 2, 4, 6 and 8 h group, the level of ALT and AST in- creased, especially in 8 h group, which were significantly different from 6 h group＇s. Under light mi- croscope, there was no significant change in liver 2 and 4 h after brain death. However, in 8 h after brain death, liver cells degenerated significantly, liver cord structure disappeared!, some liver cells nec- rosis, which was consistent with the results of apoptosis index. The levels; of IL-1β IL-6, IL-8, TNF-α were obviously increased in a time dependent manner compared with sham group. Conclusions Brain death could lead to the damage of liver function and morphology and this injury aggravated with time, which might be relevant with the production of inflammatory mediators. 8 h after brain death, there were obvious chan^ze in the liver function and moroholouv.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2013年第12期920-924,共5页
Chinese Journal of Hepatobiliary Surgery
基金
武汉市科技攻关项目（201161038344-01）
湖北省自然科学基金（2012FFA044）
武汉市科技局公共服务平台建设计划项目（2013060705010326）
关键词
脑死亡
炎症因子
凋亡
兔
Brain deathl Inflammatory factor Apoptosis
Rabbit
