CAJ | 학술논문

目的探讨缺血后处理（IPO）对肝硬化大鼠肝脏缺血-再灌注损伤（IRI）的保护作用及其免疫机制。方法按随机数字表法将30只肝硬化模型SD大鼠随机分为IPO组、IRI组和单纯肝切除组（肝切组），各10只。IPO组先切除40％肝脏，阻断第一肝门20 min，然后反复缺血-再灌注3次，最后持续再灌注；IRI组，切除40％肝脏，阻断第一肝门20 min后持续再灌注；肝切组切除40％肝脏。分别于术后6、24 h抽取大鼠下腔静脉血，检测ALT、AST、分化群（CD）4+、CD8+、调节性T细胞（Treg）百分率、白细胞介素（IL）-4、IL-10水平。3组比较采用单因素方差分析，两两比较采用LSD-t检验。结果恢复灌注6 h后，IPO组的ALT、AST分别为（1623±378）、（1993±469）U/L， IRI组相应为（2690±549）、（3020±577）U/L，IPO组ALT、AST明显低于IRI组（LSD-t=-4.21，-3.72；P<0.05）。恢复灌注24 h后，IPO组的ALT、AST分别为（307±76）、（555±137）U/L，IRI组相应为（518±105）、（1050±355） U/L，IPO组ALT、AST亦明显低于IRI组（LSD-t=-4.06，-3.37；P<0.05）。恢复灌注6 h后，IPO组CD4+、CD8+、CD4+/ CD8+比值、Treg、IL-4、 IL-10分别为（57±5）%、（25±3）%、2.3±0.5、（8.9±0.4）%、（1.27±0.25）mg/L、（0.61±0.03）mg/L，IRI组相应为（52±6）%、（12±3）%、4.5±0.8、（7.3±0.3）%、（0.66±0.11）mg/L、（0.34±0.06）mg/L，IPO组CD8+、Treg、IL-4、IL-10较IRI组明显升高，CD4+/ CD8+比值明显降低（LSD-t=7.74，6.67，5.52，9.31，-6.69；P<0.05）。结论 IPO可能通过减轻免疫损伤发挥对肝硬化大鼠肝脏IRI的保护作用。
목적탐토결혈후처리（IPO）대간경화대서간장결혈-재관주손상（IRI）적보호작용급기면역궤제。방법안수궤수자표법장30지간경화모형SD대서수궤분위IPO조、IRI조화단순간절제조（간절조），각10지。IPO조선절제40％간장，조단제일간문20 min，연후반복결혈-재관주3차，최후지속재관주；IRI조，절제40％간장，조단제일간문20 min후지속재관주；간절조절제40％간장。분별우술후6、24 h추취대서하강정맥혈，검측ALT、AST、분화군（CD）4+、CD8+、조절성T세포（Treg）백분솔、백세포개소（IL）-4、IL-10수평。3조비교채용단인소방차분석，량량비교채용LSD-t검험。결과회복관주6 h후，IPO조적ALT、AST분별위（1623±378）、（1993±469）U/L， IRI조상응위（2690±549）、（3020±577）U/L，IPO조ALT、AST명현저우IRI조（LSD-t=-4.21，-3.72；P<0.05）。회복관주24 h후，IPO조적ALT、AST분별위（307±76）、（555±137）U/L，IRI조상응위（518±105）、（1050±355） U/L，IPO조ALT、AST역명현저우IRI조（LSD-t=-4.06，-3.37；P<0.05）。회복관주6 h후，IPO조CD4+、CD8+、CD4+/ CD8+비치、Treg、IL-4、 IL-10분별위（57±5）%、（25±3）%、2.3±0.5、（8.9±0.4）%、（1.27±0.25）mg/L、（0.61±0.03）mg/L，IRI조상응위（52±6）%、（12±3）%、4.5±0.8、（7.3±0.3）%、（0.66±0.11）mg/L、（0.34±0.06）mg/L，IPO조CD8+、Treg、IL-4、IL-10교IRI조명현승고，CD4+/ CD8+비치명현강저（LSD-t=7.74，6.67，5.52，9.31，-6.69；P<0.05）。결론 IPO가능통과감경면역손상발휘대간경화대서간장IRI적보호작용。
ObjectiveTo investigate the protective effects and its mechanism of ischemia postconditioning (IPO) in hepatic ischemia-reperfusion injury (IRI) in liver cirrhotic rats.MethodsThirty liver cirrhotic Sprague-Dawley (SD) rats were randomly divided into three groups according to the random table methods: ischemia postconditioning (IPO) group, IRI group, and pure hepatectomy (PH) group with 10 rats in each group. Rats in IPO group underwent partial hepatectomy (40%), and the first portal was occluded for 20 min, then 3 times of ischemia-reperfusion were performed, and ifnally continuous reperfusion. Rats in IRI group underwent partial hepatectomy (40%), and the ifrst portal was occluded for 20 min, then continuous reperfusion was performed. Rats in PH group underwent partial hepatectomy (40%) only. Inferior vena cava blood was collected at 6, 24 h after operation. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), proportion of cluster of differentiation (CD) 4+, CD8+, regulatory T cells (Treg) and levels of interleukin (IL)-4, IL-10 were tested. Comparison of three groups was conducted by one way analysis of variance and pairwise comparison by LSD-t test.ResultsAfter 6 h reperfusion, levels of ALT and AST in IPO group [(1 623±378) , (1 993±469) U/L] were signiifcantly lower than those in IRI group [(2 690±549) , (3 020±577) U/L] (LSD-t=-4.21,-3.72; P<0.05). After 24 h reperfusion, levels of ALT and AST in IPO group [(307±76) , (555±137) U/L] were still signiifcantly lower than those in IRI group [(518±105) , (1 050±355) U/L] (LSD-t=-4.06,-3.37;P<0.05). After 6 h reperfusion, proportion of CD4+, CD8+, CD4+/CD8+ ratio, Treg, and levels of IL-4, IL-10 in IPO group were (57±5) %, (25±3) %, 2.3±0.5, (8.9±0.4) %, (1.27±0.25) mg/L, (0.61±0.03) mg/L, respectively. While in IRI group, they were (52±6)%, (12±3) %, 4.5±0.8, (7.3±0.3) %, (0.66±0.11) mg/L, (0.34±0.06) mg/L, respectively. In IPO group, CD8+, Treg, IL-4 and IL-10 increased signiifcantly, while CD4+/CD8+ ratio decreased signiifcantly, compared with those in IRI group (LSD-t= 7.74, 6.67, 5.52, 9.31,-6.69;P<0.05).ConclusionIPO can prevent from hepatic IRI injury in liver cirrhotic rats through decreasing the immune injury.