摘要
目的 观察家兔胆管缺血再灌注损伤模型中Toll样受体4（TLR4）的动态表达过程,探讨胆管缺血再灌注损伤（I/R）与TLR4激活的相关性.方法 建立家兔胆管缺血再灌注模型,对照组仅行解剖肝门手术,不进行缺血及再灌注,实验组各组缺血时间均为2h,再灌注时间分别为0、6、12、18、24 h,在不同的再灌注时间点取材,通过光镜及电镜观察胆管损伤情况,免疫组织化学观察TLR4在胆管上皮细胞上的表达,检测静脉血中总胆红素（TBIL）、谷氨酰转肽酶（GGT）、碱性磷酸酶（AKP）的表达,并进行统计学分析.结果 实验组在不同的再灌注时间点,胆管上皮细胞内可见有TLR4的表达,阳性细胞数分别为假手术组（8±2）个,I/R 0、6、12、18、24h组为（26±11）、（49±6）、（98±14）、（38±7）、（18±5）个,各实验组各组与假手术组比较,差异有统计学意义（P＜0.05）;TBIL、GGT、AKP指标随着再灌注时间延长而逐渐升高,12h达高峰[分别为ALP：（3.22±0.82） IU/L;GGT：（96.17 ±23.20） IU/L;TBIL：（6.30±1.03） μmol/L]后逐渐下降,实验组较对照组变化明显,差异均有统计学意义（P＜0.05）.结论 TLR4的激活参与了家兔胆管缺血再灌注损伤的过程;承受2h以内的缺血再灌注损伤后的肝细胞、胆管上皮以细胞肿胀、线粒体肿胀等可逆性损伤为主;TBIL、GGT、AKP可作为检测胆管缺血再灌注损伤的指标.
Objective To investigate the dynamicexpression process of toll-like receptor 4 （TLR4） in rabbits model when the bile duct is in ischemia-reperfusion （I/R） injury,explore the relationship between the I/R injury of bile duct and the activation of TLR4.Methods Creat rabbits model of bile duct I/R injury.The control group only dissect the Hepatic portal,without ischemia and reperfusion,the experimental group in each group ischemia time was 2 hours and reperfusion time was 0,6,12,18,24 h,at different reperfusion time point draw and observed the injury of bile duct by optical microscopy and electron microscopy,through immunohistochemistry to observe the expression of TLR4 in the bile duct epithelial cell,testing the expression of R-glutamyltranspeptidase （GGT）,alkaline phosphatase （AKP）,total bilirubin （TBIL） of veinal blood,and statistical analysis.Results At different reperfusion time point,TLR4 was expressed in bile duct epithelial cell of experimental group,the numbers of positive cells in each group is sham operation group：8 ±2;I/R 0,6,12,18,24 h group was 26 ± 11,49 ±6,98 ± 14,38 ± 7,18 ± 5,experimental group compared with the control group,the difference was statistically significant （P ＜ 0.05）.With the extension of reperfusion time,the TBIL,GGT,AKP gradually increased,and gradually decreased after peaked at 12 hours [respectively ALP：（3.22 ± 0.82） IU/L;GGT：（96.17 ± 23.20） IU/L;TBIL：（6.30 ± 1.03） μmol/L],the change between the experimental group and the control group was significantly,the difference was statistically significant （P ＜ 0.05）.Conclusion The activation of TLR4 involved in the progress of I/R injury of rabbits,irreversible damage such as cell swelling and mitochondrial swelling will be happened in the liver cell and bile duct epithelial cell,when within two hours of I/R injury,TBIL,GGT,AKP can be an indicator as the detection of bile duct I/R injury.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2015年第6期1336-1338,共3页
Chinese Journal of Experimental Surgery
关键词
肝移植
胆管缺血再灌注损伤
TOLL样受体4
Liver transplantation
Ischemia-reperfusion injury of bile duct
Toll-like receptor 4
