CAJ | 학술논문

目的研究胆道相对热缺血(RWI)对肝移植术后所产生的胆汁性质及胆盐构成的影响.方法将32只SD大鼠按随机数字表法分为第Ⅰ～Ⅳ组(分别为对照组、RWI 0 min、30 min和60 min组).测定自体原位肝移植术后早期所产生的胆汁中磷脂(PL)、总胆汁酸盐(TBA)水平及PL/TBA值,并检测各亲水性和疏水性胆汁酸盐的变化.结果与Ⅰ组相比,Ⅱ组PL浓度略降低,但差异无统计学意义(P＞0.05);Ⅲ组的PL及TBA浓度比Ⅱ组明显降低(P＜0.05),Ⅲ组的PL/TBA值略低于Ⅱ组,但差异不具有统计学意义(P＞0.05).Ⅱ组与Ⅲ组的亲水性胆盐浓度、疏水性胆盐浓度差异均无统计学意义(P＞0.05).与其他三组相比,Ⅳ组PL浓度、TBA浓度、PL/TBA值、亲水性胆盐牛磺-β-鼠胆酸(T-3-MC)的摩尔分数均下降(P＜0.05),疏水性胆盐牛磺胆酸(TC)的摩尔分数升高(P＜0.05).结论胆道相对热缺血会导致肝移植术后胆汁中磷脂/胆盐比例及胆汁中疏水/亲水性质发生改变,这种变化随着RWI时间的延长而加重.当RWI时间达60 min时,胆汁成分变化明显,“去垢”作用增强.肝移植时应尽快完成肝动脉吻合,最好能将相对热缺血时间控制在30 min以内.
목적 연구담도상대열결혈(RWI)대간이식술후소산생적담즙성질급담염구성적영향.방법 장32지SD대서안수궤수자표법분위제Ⅰ～Ⅳ조(분별위대조조、RWI 0 min、30 min화60 min조).측정자체원위간이식술후조기소산생적담즙중린지(PL)、총담즙산염(TBA)수평급PL/TBA치,병검측각친수성화소수성담즙산염적변화.결과여Ⅰ조상비,Ⅱ조PL농도략강저,단차이무통계학의의(P＞0.05);Ⅲ조적PL급TBA농도비Ⅱ조명현강저(P＜0.05),Ⅲ조적PL/TBA치략저우Ⅱ조,단차이불구유통계학의의(P＞0.05).Ⅱ조여Ⅲ조적친수성담염농도、소수성담염농도차이균무통계학의의(P＞0.05).여기타삼조상비,Ⅳ조PL농도、TBA농도、PL/TBA치、친수성담염우광-β-서담산(T-3-MC)적마이분수균하강(P＜0.05),소수성담염우광담산(TC)적마이분수승고(P＜0.05).결론담도상대열결혈회도치간이식술후담즙중린지/담염비례급담즙중소수/친수성질발생개변,저충변화수착RWI시간적연장이가중.당RWI시간체60 min시,담즙성분변화명현,“거구”작용증강.간이식시응진쾌완성간동맥문합,최호능장상대열결혈시간공제재30 min이내.
Objective To explore the effect of relative warm ischemia (RWI) on bile nature and component in rats self-liver transplantation.Methods Thirty two rats were randomly divided into group Ⅰ (control group),group Ⅱ (RWI 0 min),group Ⅲ (RWI 30 min),and group Ⅳ (RWI 60 min).The levels of bile phospholipids (PL),total bile acids (TBA),and PL/TBA ratio were detected early after self-liver transplantation.The concentration changes of hydrophilic and hydrophobic bile acids were examined.Results Only PL concentration of group Ⅱ seemed to be lower than that of group Ⅰ (P ＜ 0.05),without any change for other indexes.Compared with group Ⅱ,only the PL and TBA concentrations of the group Ⅲ were decreased significantly (P ＜ 0.05),and no significant difference was found between two groups on PL/TBA ratio and mole fractions of bile acids (P ＞ 0.05).Compared to group Ⅱ,the concentrations of PL and TBA,PL/TBA ratio,and the mole fraction of taurocholic-β-mouse acid (T-β-MC) were much lower in group Ⅳ (P ＜ 0.05),and the mole fraction of taurocholic acid (TC) were higher in group Ⅳ (P ＜ 0.05).Conclusions RWI caused changes of PL/TBA ratio,hydrophilicity and hydrophobicity of bile early after liver transplantation,and the changes were directly proportional to the RWI time.The property of bile in early transplantation seemed not to be changed when the relative warm ischemia time was less than 30 min.When the RWI time was longer than 60 min,the bile component was changed obviously and the toxicity was increased.In liver transplantation,arterial anastomosis should be completed as soon as possible,and the RWI time should be less than 30 min.