• 1. 中國醫(yī)科大學附屬第一醫(yī)院超聲科(遼寧沈陽 110001);;
  • 2. 中國醫(yī)科大學附屬第一醫(yī)院普通外科教研室器官移植科(遼寧沈陽 110001);;
  • 3. 中國醫(yī)科大學附屬第一醫(yī)院檢驗科(遼寧沈陽 110001);

目的  探討頻譜多普勒超聲檢測大鼠肝缺血/再灌注(I/R)后入肝血流量變化與血清腫瘤壞死因子-α(TNF-α)及白介素-1β(IL-1β)水平變化之間的關系。
方法  Pringle 法建立肝臟缺血15min再灌注模型,應用頻譜多普勒超聲檢測再灌注后1、6及24h不同時間點肝動脈及門靜脈的入肝血流量,計算總血流量(FV),觀測肝I/R后入肝血流量的變化情況。檢測各時間點血清TNF-α及IL-1β水平的變化,分析FV與TNF-α及IL-1β之間的相關性。
結果  I/R組再灌注后1及6h 的FV分別為(52.08±11.88) mL/min及(44.69±8.75) mL/min,較假手術組術后1 及6h的(85.32±29.85) mL/min和(81.41±28.67) mL/min明顯減少(P<0.05);再灌注后24hFV2組間的差異無統(tǒng)計學意義(P>0.05)。I/R組再灌注后1h血清TNF-α含量為(310.52±39.83) pg/mL,較假手術組術后1h的(240.74±31.65) pg/mL高(P<0.05);再灌注或手術后6 及24h的TNF-α含量2組間差異無統(tǒng)計學意義(P>0.05)。I/R組再灌注后1及6h血清IL-1β含量分別為(38.08±3.73) pg/mL和(27.44±6.11) pg/mL,較假手術組術后1 和6h組的(22.03±0.79) pg/mL及(21.78±0.71) pg/mL高(P<0.01, P<0.05); 再灌注后24h的血清IL-1β含量2組間差異無統(tǒng)計學意義(P>0.05)。FV與TNF-α及IL-1β之間存在負相關關系(r=-0.43,P<0.05;r=-0.46,P<0.05)。
結論  頻譜多普勒超聲能夠通過檢測入肝血流量的變化間接判斷肝臟微循環(huán)狀態(tài),肝I/R后入肝血流量減少,且血流量的減少可能與TNF-α和IL-1β的過表達有關。

引用本文: 張云飛,闕艷紅,王學梅,李弘,代娣,李曉姝. 頻譜多普勒超聲檢測大鼠肝缺血/再灌注后入肝血流量變化與血清TNF-α及IL-1β水平變化之間的關系△. 中國普外基礎與臨床雜志, 2013, 20(7): 742-745. doi: 復制

1. Uhlmann D, Pietsch UC, Ludwig S, et al. Assessment of hepatic ischemia-reperfusion injury by simultaneous measurement of tissuepO2, pCO2, and pH[J]. Microvasc Res, 2004, 67(1):38-47.
2. Shibuya H, Ohkohehi N, Tsukamoto S, et al. Tumour necrosis factor-induced superoxid-mediated neutrophil accumulation in cold ischemia/reperfusion in rat liver[J]. Hepatology, 1997, 26(1):113-120.
3. Okajima K, Harada N, Kushimoto S, et al. Role of microthrombusformation in the development of ischemia/reperfusion-induced liver injury in rats[J]. Thromb Haemost, 2002, 88(3):473-480.
4. Shito M, Wakabayashi G, Ueda M, et al. Interleukin receptor blockade reduces tumour necrosis factor production, tissue injury and mortality after hepatic ischemia-reperfusion in the rat[J]. Transplantation, 1997, 63(1):143-148.
5. Karaman K, Tirnaksiz MB, Ulusu N, et al. Effects of dexameth-asone on ischemia reperfusion injury following pringle maneuver[J]. Hepatogastroenterology, 2011, 58(106):465-471.
6. Lin HC, Lee TK, Tsai CC, et al. Ischemic postconditioning protects liver from ischemia-reperfusion injury by modulatingmitochondrial permeability transition[J]. Transplantation, 2012,.
7. 任鋒, 張海燕, 樸正福, 等. 糖原合成酶激酶-3β在肝臟熱缺血再灌注損傷中的作用及其干預[J]. 中華肝臟病雜志, 2011, 19(7):547-551.
8. Matsumi J, Morimatsu H, Matsusaki T, et al. Heme breakdown and ischemia/reperfusion injury in grafted liver during living donorliver transplantation[J]. Int J Mol Med, 2012, 29(2):135-140.
9. Guo JY, Yang T, Sun XG, et al. Ischemic postconditioning attenuates liver warm ischemia-reperfusion injury through Akt-eNOS-NO-HIF pathway[J]. J Biomed Sci, 2011, 18:79.
10. Zhang J, Hu W, Xing W, et al. The protective role of CD59 and pathogenic role of complement in hepatic ischemia and reperfusion injury[J]. Am J Pathol, 2011, 179(6):2876-2884.
11. Cheng MX, Chen ZZ, Cai YL, et al. AstragalosideⅣprotects against ischemia reperfusion in a murine model of orthotopic liver transplantation[J]. Transplant Proc, 2011, 43(5):1456-1461.
12. Xing WJ, Kong FJ, Li GW, et al. Calcium-sensing receptorsinduce apoptosis during simulated ischaemia-reperfusion in Buffalorat liver cells[J]. Clin Exp Pharmacol Physiol, 2011, 38(9):605-612.
13. Lehwald N, Tao GZ, Jang KY, et al. Wnt-β-catenin signalingprotects against hepatic ischemia and reperfusion injury in mice[J]. Gastroenterology, 2011, 141(2):707-718.
14. Wu C, Xia Y, Wang P, et al. Triptolide protects mice from ischemia/reperfusion injury by inhibition of IL-17 production[J]. IntImmunopharmacol, 2011, 11(10):1564-1572.
15. Jin C, Zhang PJ, Bao CQ, et al. Protective effects of Atractylodes macrocephala polysaccharide on liver ischemia-reperfusion injury and its possible mechanism in rats[J]. Am J Chin Med, 2011, 39(3):489-502.
16. 石臣磊, 秦華東, 丁超. 依達拉奉對肝缺血再灌注損傷逆轉作用的研究[J]. 中國普外基礎與臨床雜志, 2011, 18(8):887-889.
17. (4):318-321.
18. Park J, Kang JW, Lee SM. Activation of the cholinergic anti-inflammatory pathway by nicotine attenuates hepatic ischemia/reperfusion injury via heme oxygenase-1 induction[J]. Eur J Pharmacol, 2013, 707(1-3):61-70.
19. Shuh M, Bohorquez H, Loss GE Jr, et al. Tumor necrosisfactor-α:life and death of hepatocytes during liver ischemia/reperfusion injury[J]. Ochsner J, 2013, 13(1):119-130.
20. Lim EJ, Do GM, Shin JH, et al. Protective effects of Acanthopanax divaricatus vat. albeofructus and its active compound on ischemia-reperfusion injury of rat liver[J]. Biochem Biophys Res Commun, 2013, 432(4):599-605.
21. 冉江華, 郭永章, 李立, 等. 重組人生長激素對大鼠肝臟缺血再灌注損傷的保護作用[J]. 中國普外基礎與臨床雜, 2006, 13(5):555-559.
22. Kato A, Gabay C, Okaya T, et al. Specific role of interleukin-1 in hepatic neutrophil recruitment after ischemia/reperfusion[J]. Am J Pathol, 2002, 161(5):1797-803.
23. Langdale LA, Wilson L, Jurkovich GJ, et al. Effects of immuno-modulation with interferon-gamma on hepatic ischemia-reperfusioninjury[J]. Shock, 1999, 11(5):356-361.
24. Guidi L, Tricerri A, Costanzo M, et al. Interleukin-6 release in the hepatic blood outflow during normothermic liver ischaemia in humans[J]. Dig Liver Dis, 2003, 35(6):409-415.
25. Ren F, Duan Z, Cheng Q, et al. Inhibition of glycogen synthase kinase 3 beta ameliorates liver ischemia reperfusion injury by way of an interleukin-10-mediated immune regulatory mechanism[J]. Hepatology, 2011, 54(2):687-696.
26. Kato A, Graul-Layman A, Edwards MJ, et al. Promotion of hepatic ischemia/reperfusion injury by IL-12 is independent of STAT4[J]. Transplantation, 2002, 73(7):1142-1145.
27. 王學梅, 張云飛, 李弘, 等. 彩色多普勒超聲在觀測肝缺血再灌注后入肝血流量變化作用[J]. 生物醫(yī)學工程與臨床, 2012,.
28. (3):265-271.
  1. 1. Uhlmann D, Pietsch UC, Ludwig S, et al. Assessment of hepatic ischemia-reperfusion injury by simultaneous measurement of tissuepO2, pCO2, and pH[J]. Microvasc Res, 2004, 67(1):38-47.
  2. 2. Shibuya H, Ohkohehi N, Tsukamoto S, et al. Tumour necrosis factor-induced superoxid-mediated neutrophil accumulation in cold ischemia/reperfusion in rat liver[J]. Hepatology, 1997, 26(1):113-120.
  3. 3. Okajima K, Harada N, Kushimoto S, et al. Role of microthrombusformation in the development of ischemia/reperfusion-induced liver injury in rats[J]. Thromb Haemost, 2002, 88(3):473-480.
  4. 4. Shito M, Wakabayashi G, Ueda M, et al. Interleukin receptor blockade reduces tumour necrosis factor production, tissue injury and mortality after hepatic ischemia-reperfusion in the rat[J]. Transplantation, 1997, 63(1):143-148.
  5. 5. Karaman K, Tirnaksiz MB, Ulusu N, et al. Effects of dexameth-asone on ischemia reperfusion injury following pringle maneuver[J]. Hepatogastroenterology, 2011, 58(106):465-471.
  6. 6. Lin HC, Lee TK, Tsai CC, et al. Ischemic postconditioning protects liver from ischemia-reperfusion injury by modulatingmitochondrial permeability transition[J]. Transplantation, 2012,.
  7. 7. 任鋒, 張海燕, 樸正福, 等. 糖原合成酶激酶-3β在肝臟熱缺血再灌注損傷中的作用及其干預[J]. 中華肝臟病雜志, 2011, 19(7):547-551.
  8. 8. Matsumi J, Morimatsu H, Matsusaki T, et al. Heme breakdown and ischemia/reperfusion injury in grafted liver during living donorliver transplantation[J]. Int J Mol Med, 2012, 29(2):135-140.
  9. 9. Guo JY, Yang T, Sun XG, et al. Ischemic postconditioning attenuates liver warm ischemia-reperfusion injury through Akt-eNOS-NO-HIF pathway[J]. J Biomed Sci, 2011, 18:79.
  10. 10. Zhang J, Hu W, Xing W, et al. The protective role of CD59 and pathogenic role of complement in hepatic ischemia and reperfusion injury[J]. Am J Pathol, 2011, 179(6):2876-2884.
  11. 11. Cheng MX, Chen ZZ, Cai YL, et al. AstragalosideⅣprotects against ischemia reperfusion in a murine model of orthotopic liver transplantation[J]. Transplant Proc, 2011, 43(5):1456-1461.
  12. 12. Xing WJ, Kong FJ, Li GW, et al. Calcium-sensing receptorsinduce apoptosis during simulated ischaemia-reperfusion in Buffalorat liver cells[J]. Clin Exp Pharmacol Physiol, 2011, 38(9):605-612.
  13. 13. Lehwald N, Tao GZ, Jang KY, et al. Wnt-β-catenin signalingprotects against hepatic ischemia and reperfusion injury in mice[J]. Gastroenterology, 2011, 141(2):707-718.
  14. 14. Wu C, Xia Y, Wang P, et al. Triptolide protects mice from ischemia/reperfusion injury by inhibition of IL-17 production[J]. IntImmunopharmacol, 2011, 11(10):1564-1572.
  15. 15. Jin C, Zhang PJ, Bao CQ, et al. Protective effects of Atractylodes macrocephala polysaccharide on liver ischemia-reperfusion injury and its possible mechanism in rats[J]. Am J Chin Med, 2011, 39(3):489-502.
  16. 16. 石臣磊, 秦華東, 丁超. 依達拉奉對肝缺血再灌注損傷逆轉作用的研究[J]. 中國普外基礎與臨床雜志, 2011, 18(8):887-889.
  17. 17. (4):318-321.
  18. 18. Park J, Kang JW, Lee SM. Activation of the cholinergic anti-inflammatory pathway by nicotine attenuates hepatic ischemia/reperfusion injury via heme oxygenase-1 induction[J]. Eur J Pharmacol, 2013, 707(1-3):61-70.
  19. 19. Shuh M, Bohorquez H, Loss GE Jr, et al. Tumor necrosisfactor-α:life and death of hepatocytes during liver ischemia/reperfusion injury[J]. Ochsner J, 2013, 13(1):119-130.
  20. 20. Lim EJ, Do GM, Shin JH, et al. Protective effects of Acanthopanax divaricatus vat. albeofructus and its active compound on ischemia-reperfusion injury of rat liver[J]. Biochem Biophys Res Commun, 2013, 432(4):599-605.
  21. 21. 冉江華, 郭永章, 李立, 等. 重組人生長激素對大鼠肝臟缺血再灌注損傷的保護作用[J]. 中國普外基礎與臨床雜, 2006, 13(5):555-559.
  22. 22. Kato A, Gabay C, Okaya T, et al. Specific role of interleukin-1 in hepatic neutrophil recruitment after ischemia/reperfusion[J]. Am J Pathol, 2002, 161(5):1797-803.
  23. 23. Langdale LA, Wilson L, Jurkovich GJ, et al. Effects of immuno-modulation with interferon-gamma on hepatic ischemia-reperfusioninjury[J]. Shock, 1999, 11(5):356-361.
  24. 24. Guidi L, Tricerri A, Costanzo M, et al. Interleukin-6 release in the hepatic blood outflow during normothermic liver ischaemia in humans[J]. Dig Liver Dis, 2003, 35(6):409-415.
  25. 25. Ren F, Duan Z, Cheng Q, et al. Inhibition of glycogen synthase kinase 3 beta ameliorates liver ischemia reperfusion injury by way of an interleukin-10-mediated immune regulatory mechanism[J]. Hepatology, 2011, 54(2):687-696.
  26. 26. Kato A, Graul-Layman A, Edwards MJ, et al. Promotion of hepatic ischemia/reperfusion injury by IL-12 is independent of STAT4[J]. Transplantation, 2002, 73(7):1142-1145.
  27. 27. 王學梅, 張云飛, 李弘, 等. 彩色多普勒超聲在觀測肝缺血再灌注后入肝血流量變化作用[J]. 生物醫(yī)學工程與臨床, 2012,.
  28. 28. (3):265-271.