CAJ | 학술논문

目的观察术前间断低氧预适应对大鼠70％肝切术后缺血再灌注损伤肝脏凋亡相关蛋白Bcl-2和Bax表达的影响.方法健康清洁级SD大鼠54只,用SPSS软件随机分为3组,每组18只:(1)肝切除组(PH组),切除肝脏的左叶和中叶(约占总肝重的70％);(2)缺血再灌注组(IR组),即在肝门阻断下切除肝脏的左叶和中叶,肝门阻断20 min后开放血流,残余肝脏发生了缺血再灌注过程;(3)间断低氧预适应组(IHP组),术前1周将大鼠置于氧气体积分数为10％的低氧环境中,每天1h.1周后在肝门阻断下行肝切除术(同IR组).各组分别于术后12、24、48 h进行取材检测,用全自动生化分析仪检测血清谷丙转氨酶(ALT)、谷草转氨酶(AST)含量,采用免疫组化方法检测残余肝组织Bcl-2、Bax表达情况.结果在术后各时间点,IR组和IHP组血清ALT和AST水平均显著高于PH组,但IHP组明显低于IR组.与IR组相比,IHP组术后各时间点肝脏Bcl-2蛋白表达显著升高,而Bax蛋白表达显著下降.差异均有统计学意义(P＜0.05).结论间断低氧预适应对残余肝脏缺血再灌注损伤具有保护作用,其途径可能是通过促进抗凋亡蛋白Bcl-2表达和抑制促凋亡蛋白Bax表达,来减少肝细胞凋亡.
목적 관찰술전간단저양예괄응대대서70％간절술후결혈재관주손상간장조망상관단백Bcl-2화Bax표체적영향.방법 건강청길급SD대서54지,용SPSS연건수궤분위3조,매조18지:(1)간절제조(PH조),절제간장적좌협화중협(약점총간중적70％);(2)결혈재관주조(IR조),즉재간문조단하절제간장적좌협화중협,간문조단20 min후개방혈류,잔여간장발생료결혈재관주과정;(3)간단저양예괄응조(IHP조),술전1주장대서치우양기체적분수위10％적저양배경중,매천1h.1주후재간문조단하행간절제술(동IR조).각조분별우술후12、24、48 h진행취재검측,용전자동생화분석의검측혈청곡병전안매(ALT)、곡초전안매(AST)함량,채용면역조화방법검측잔여간조직Bcl-2、Bax표체정황.결과 재술후각시간점,IR조화IHP조혈청ALT화AST수평균현저고우PH조,단IHP조명현저우IR조.여IR조상비,IHP조술후각시간점간장Bcl-2단백표체현저승고,이Bax단백표체현저하강.차이균유통계학의의(P＜0.05).결론 간단저양예괄응대잔여간장결혈재관주손상구유보호작용,기도경가능시통과촉진항조망단백Bcl-2표체화억제촉조망단백Bax표체,래감소간세포조망.
Objective To observe the effects of intermittent hypoxic preconditioning on the expression of apoptosis-related Bcl-2 and Bax protein after 70％ hepatectomy combined with ischemia-reperfusion injury.Methods A total of fifty-four SD rats were randomly divided into three groups (n =18).Partial hepatectomy hroup (PH Group):Rats underwent the left and middle lobectomy of liver(70％ hepatectomy).Ischemia reperfusion group (IR group):The left and middle lobes of liver were resected during the occlusion of the hepatoduodenal ligament for 20 minutes.Residual liver underwent the process of ischemia-reperfusion.Intermittent hypoxia preconditioning group (IHP group):rats were exposed to hypoxic environment of 10％ oxygen for 1 h/d.After 7 consecutive days,the left and middle lobes of liver were resected under the portal triad clamping.At 12,24 and 48 hours after the operation,the rats were killed and detected.The serum levels of ALT and AST were determined by automatic biochemical analyzer.The expression of Bcl-2 and Bax protein in liver tissue were measured by immunohistochemistry.Results At each time point after surgery,the serum levels of ALT and AST in IR group and IHP group were higher than that of PH group,and IHP group were lower than in IR group.Compared with IR group,the expression of Bcl2 protein significantly increased and Bax protein expression significantly decreased in IHP group.All these differences were statistically significant (P ＜ 0.05).Conclusions Intermittent hypoxic preconditioning might protect residual liver against ischemia reperfusion injury,through increasing the expression of Bcl-2 protein and reducing the expression of Bcl-2 protein to decrease liver cell apoptosis.