CAJ | 학술논문

目的探讨盐酸戊乙奎醚对体外循环(CPB)后肝脏损害的保护作用及机制.方法选取32 ～ 40 kg健康的广西巴马小型猪,24头猪随机分为3组(n=8):假手术组(Sham组)、模型组(Mod组)和盐酸戊乙奎醚组(PHC组).Sham组只插管不行CPB,Mod组行CPB静脉注射生理盐水,PHC组CPB前10 min静脉注射盐酸戊乙奎醚0.1 mg/kg.3组分别于CPB前(T0)、CPB后1h(T1)、CPB结束时(T2)和术毕(T3)抽静脉血检测血清中天冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)活性和直接胆红素(DB)、总胆红素(TB)含量.3组于CPB前和CPB结束时,分别取约50μg的肝组织制成10％的组织匀浆,检测肝组织匀浆的三磷酸腺苷(ATP)、丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性并在电镜下观察肝组织的超微病理改变.结果与Sham组比较,Mod组和PHC组CPB结束时各时点AST、ALT活性和DB、TB和MDA含量升高,ATP含量和SOD活性下降(P＜0.05);与Mod组比较,PHC组CPB结束时的AST、ALTDB、TB和MD下降,ATP、SOD升高(P＜0.05),电镜下的肝组织病理损伤减轻.结论盐酸戊乙奎醚对CPB后肝脏损害有一定的保护作用,其机制可能与抗氧化清除氧自由基有关.
목적 탐토염산무을규미대체외순배(CPB)후간장손해적보호작용급궤제.방법 선취32 ～ 40 kg건강적엄서파마소형저,24두저수궤분위3조(n=8):가수술조(Sham조)、모형조(Mod조)화염산무을규미조(PHC조).Sham조지삽관불행CPB,Mod조행CPB정맥주사생리염수,PHC조CPB전10 min정맥주사염산무을규미0.1 mg/kg.3조분별우CPB전(T0)、CPB후1h(T1)、CPB결속시(T2)화술필(T3)추정맥혈검측혈청중천동안산전안매(AST)、병안산안기전이매(ALT)활성화직접담홍소(DB)、총담홍소(TB)함량.3조우CPB전화CPB결속시,분별취약50μg적간조직제성10％적조직균장,검측간조직균장적삼린산선감(ATP)、병이철(MDA)함량화초양화물기화매(SOD)활성병재전경하관찰간조직적초미병리개변.결과 여Sham조비교,Mod조화PHC조CPB결속시각시점AST、ALT활성화DB、TB화MDA함량승고,ATP함량화SOD활성하강(P＜0.05);여Mod조비교,PHC조CPB결속시적AST、ALTDB、TB화MD하강,ATP、SOD승고(P＜0.05),전경하적간조직병리손상감경.결론 염산무을규미대CPB후간장손해유일정적보호작용,기궤제가능여항양화청제양자유기유관.
Objective To investigate the effects of penehyclidine hydrochloride on liver injury induced by cardiopulmonary bypass (CPB) in Guangxi bamaminiature pig.Methods Twenty-seven Bama miniature pigs weighted 32-40 kg were chosen,three pigs were used for sampling blood,another twentyfour pigs were used for cardiopulmonary bypass (CPB).Twenty-four pigs were randomly divided into three groups (n=8 each):group Sham,group Mod,and group PHC.Propofol,fentanyl and vecuronium were continued by intravenous injection and inhaled isoflurane interruptly for anesthesic maintain.CPB was performed on mild hypothermic beating heart for 120 min.Pnehyclidine hydrochloride 0.1 mg/kg was injected intravenously before 10 min CPB.Blood samples were collected for aspartate aminotransferase (AST),alanine transaminase (ALT),direct bilirubin (DB) and total bilirubin (TB) before CPB (T0),after CPB 1 h (T1),CPB cease (T2) and operation cease (T3).The content of ATP,MDA and SOD in liver tissue at befor and after CPB were measured and the pathologic change of liver was evaluated by electron microscope.Results The levels of ALT,AST,DB and TB in group Mod and group PHC were significantly higher at T1-T3 than those in group Sham (P ＜ 0.05).ATP,SOD were lower and MDA was higher significantly in group Mod and group PHC after CPB than that in group Sham (P ＜ 0.05).Compared with the group Mod,The levels of ALT,AST,DB,TB and MDA were lower and ATP,SOD were higher significantly respectively in group PHC (P ＜ 0.05).The electron microscopec examination showed that histologic damage was significantly reduced in group PHC compared with group Mod.Conclusion Pnehyclidine hydrochloride can attenuate Iiver injury induced by CPB,antioxygen to remove oxygen free radical in liver may be the mechanism.