CAJ | 학술논문

目的：观察腹腔神经丛阻滞（ NCPB）对肝部分切除术（ PH）大鼠残余肝细胞凋亡的影响。方法60只清洁雄性SD大鼠，构建大鼠70％PH模型，随机分为对照组和NCPB组。 NCPB组在术后12h开始给予双侧0.5％利多卡因经皮NCPB，1次/d，而对照组以0.9％生理盐水替换。分别于术后第1、3、7d测定残肝功能、血流量和凋亡相关蛋白Bcl-2相关X蛋白（ BAX ）和B细胞淋巴瘤/白血病-2（ Bcl-2）的表达。结果 NCPB组大鼠的谷草转氨酶（AST）和谷丙转氨酶（ALT）在PH术后第1、3、7d均不同程度地低于对照组（ P＜0.01或P＜0.05）；对照组PH术后肝细胞出现明显的脂肪变性，且较多见小灶性肝细胞坏死和小片状肝细胞坏死，而NCPB组肝组织变性坏死明显减轻；与对照组相比，NCPB组大鼠的肝脏血流量在各个时间点均显著高于对照组（P＜0.01）； PH术后两组肝组织BAX均逐渐下降，但在相应时间点NCPB组显著低于对照组（P＜0.05或P＜0.01），而Bcl-2显著升高，但NCPB组却显著高于对照组（P＜0.01），在第3d和第7d NCPB组的BAX/Bcl-2比值显著低于对照组（ P＜0.01）。结论 NCPB减轻大鼠PH术后早期肝功能损害，可能与抑制PH术后早期肝细胞凋亡有关。
목적：관찰복강신경총조체（ NCPB）대간부분절제술（ PH）대서잔여간세포조망적영향。방법60지청길웅성SD대서，구건대서70％PH모형，수궤분위대조조화NCPB조。 NCPB조재술후12h개시급여쌍측0.5％리다잡인경피NCPB，1차/d，이대조조이0.9％생리염수체환。분별우술후제1、3、7d측정잔간공능、혈류량화조망상관단백Bcl-2상관X단백（ BAX ）화B세포림파류/백혈병-2（ Bcl-2）적표체。결과 NCPB조대서적곡초전안매（AST）화곡병전안매（ALT）재PH술후제1、3、7d균불동정도지저우대조조（ P＜0.01혹P＜0.05）；대조조PH술후간세포출현명현적지방변성，차교다견소조성간세포배사화소편상간세포배사，이NCPB조간조직변성배사명현감경；여대조조상비，NCPB조대서적간장혈류량재각개시간점균현저고우대조조（P＜0.01）； PH술후량조간조직BAX균축점하강，단재상응시간점NCPB조현저저우대조조（P＜0.05혹P＜0.01），이Bcl-2현저승고，단NCPB조각현저고우대조조（P＜0.01），재제3d화제7d NCPB조적BAX/Bcl-2비치현저저우대조조（ P＜0.01）。결론 NCPB감경대서PH술후조기간공능손해，가능여억제PH술후조기간세포조망유관。
Objective To investigate the effects of neurolytic celiac plexus block ( NCPB) on the apoptosis of residual liver cells after partial hepatectomy ( PH) in rats.Methods Sixty clean male SD rats were randomly di-vided into control group and NCPB group after 70%PH.NCPB group received pertaneous neurolytic celiac plexus block with 0.5%lidocaine(one time/day),and control group received the same procedures , but physiological saline was injected instead of 0.5%lidocaine.The residual liver function , liver blood flow and expressions of apoptosis-related protein BAX and Bcl-2 were determined at 1 day,3 days and 7 days after PH.Results The aspartate amin-otransferase(AST) and alanine aminotransferase (ALT) content of PH rats in the NCPB group was significantly low-er than that of rats in control group at 1 day,3 days and 7 days (P<0.01 or P<0.05).The hepatocytes showed more steatosis,and spotty or patchy necrosis after PH in the control group than in the NCPB group .At all the re-spective time points ,the liver blood flow of the NCPB group was higher than that of the control group ( P<0.01 ) . The hepatic BAX expressions were gradually decreased in the two groups after PH , but at the corresponding time point it was significantly lower in NCPB group than that of the control group (P<0.05 or P<0.01).The Bcl-2 ex-pressions were increased significantly ,which was remarkably higher in the NCPB group than that in the control group (P<0.01).At 3 days and 7 days,the BAX/Bcl-2 ratio was significantly lower in NCPB group than that in the con-trol group(P<0.01).Conclusion NCPB treatment can alleviate the early damage of liver function after PH in rats,which may be associated with the inhibition of hepatocellular apoptosis .