• 南京醫(yī)科大學(xué)附屬第一醫(yī)院肝移植中心（南京210029）;;
  • 通訊作者： 李相成;

目的　觀察缺血預(yù)處理對(duì)大鼠肝臟移植后再灌注早期核轉(zhuǎn)錄因子-κB(NF-κB)活性和TNF-α、細(xì)胞間黏附分子-1(ICAM-1)表達(dá)的影響，探討缺血預(yù)處理的保護(hù)機(jī)理。方法　建立大鼠肝臟移植模型，供肝在林格液中保存2 h，實(shí)驗(yàn)分假手術(shù)組、對(duì)照組和缺血預(yù)處理組（IP組）3組，IP組于供肝切取前夾閉第一肝門(mén)10 min，然后開(kāi)放10 min。分別于移植再灌注后 1、2、4及6 h抽血進(jìn)行肝酶學(xué)檢查，切取肝臟作NF-κB活性、TNF-α和ICAM-1表達(dá)的測(cè)定。結(jié)果　IP組肝功能得到有效改善。與假手術(shù)組比較，對(duì)照組及IP組再灌注后移植物的NF-κB活性明顯增強(qiáng)，且在1、2 h達(dá)高峰， 4 h后減弱，TNF-α和ICAM-1表達(dá)也隨之增加； 同對(duì)照組相比，IP組的NF-κB活性降低，并且在1、2 h差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）, TNF-α和ICAM-1表達(dá)亦降低。結(jié)論　缺血預(yù)處理對(duì)于供肝的保護(hù)作用可能是通過(guò)抑制再灌注早期NF-κB的活性，減少了TNF-α和ICAM-1炎癥介質(zhì)的釋放，從而減輕了移植物再灌注早期的炎癥反應(yīng)實(shí)現(xiàn)的。

引用本文： 馬躍峰,李相成,姚愛(ài)華,游偉,王學(xué)浩. 缺血預(yù)處理對(duì)大鼠肝臟移植物再灌注早期NF-κB活性的影響及意義△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(5): 531-534. doi: 復(fù)制

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2. 　涂　兵， 嚴(yán)律南， 劉智敏， 等. 缺血預(yù)處理對(duì)大鼠移植肝臟缺血再灌注損傷的保護(hù)作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2002； 9（2）∶89.
3. 　Zhang SJ, Chen S. The role of ischemic preconditioning in rat liver graft [J].Transplant Proc, 2004; 36(7)∶1970.
4. 　馬躍峰， 李相成， 游　偉. “兩袖套法”大鼠原位肝移植模型的技術(shù)改進(jìn) [J]. 中國(guó)現(xiàn)代醫(yī)學(xué)雜志， 2006； 16（2）∶229.
5. 　 Kataoka M, Shimizu H, Mitsuhashi N, et al. Effect of cold-ischemia time on C-X-C chemokine expression and neutrophil accumulation in the graft liver after orthotopic liver transplantation in rats [J]. Transplantation， 2002; 73(11)∶1730.
6. 　Serracino-Inglott F, Habib NA, Mathie RT. Hepatic ischemia-reperfusion injury [J]. Am J Surg， 2001; 181(2)∶160.
7. 　Ricciardi R, Kim RD, McDade TP, et al. NF kappa B expression during cold ischemia correlates with postreperfusion graft function [J]. J Surg Res， 2000; 93(1)∶35.
8. 　Sindram D, Rudiger HA, Upadhya AG, et al. Ischemic preconditioning protects against cold ischemic injury through an oxidative stress dependent mechanism [J]. J Hepatol， 2002; 36(1)∶78.
9. 　Nilsson B, Friman S, Wallin M, et al. The liver protective effect of ischemic preconditioning may be mediated by adenosine [J]. Transpl Int， 2000; 13 Suppl 1∶S558.
10. 　Yamamoto Y, Kume M, Yamaoka Y. Implications of heat shock proteins during liver surgery and liver perfusion [J]. Recent Results Cancer Res， 1998; 147∶157.
11. 　Jiang Y, Gu XP, Qiu YD, et al. Ischemic preconditioning decreases C-X-C chemokine expression and neutrophil accumulation early after liver transplantation in rats [J]. World J Gastroenterol， 2003; 9(9)∶2025.
12. 　Tsuyama H, Shimizu K, Yoshimoto K, et al. Protective effect of ischemic preconditioning on hepatic ischemia-reperfusion injury in mice [J]. Transplant Proc， 2000; 32(7)∶2310.
13. 　Ohkita M, Takaoka M, Shiota Y, et al. Nitric oxide inhibits endothelin-1 production through the suppression of nuclear factor kappa B [J]. Clin Sci (Lond)， 2002; 103 Suppl 48∶68S.
14. 　 Rudiger HA, Clavien PA. A cytotoxic drug against reperfusion injury? [J]. Hepatology， 2000; 31(2)∶533.
  1. 1. 　Clavien PA, Harvey PR, Strasberg SM. Preservation and reperfusion injuries in liver allografts. An overview and synthesis of current studies [J]. Transplantation, 1992; 53(5)∶957.
  2. 2. 　涂　兵， 嚴(yán)律南， 劉智敏， 等. 缺血預(yù)處理對(duì)大鼠移植肝臟缺血再灌注損傷的保護(hù)作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2002； 9（2）∶89.
  3. 3. 　Zhang SJ, Chen S. The role of ischemic preconditioning in rat liver graft [J].Transplant Proc, 2004; 36(7)∶1970.
  4. 4. 　馬躍峰， 李相成， 游　偉. “兩袖套法”大鼠原位肝移植模型的技術(shù)改進(jìn) [J]. 中國(guó)現(xiàn)代醫(yī)學(xué)雜志， 2006； 16（2）∶229.
  5. 5. 　 Kataoka M, Shimizu H, Mitsuhashi N, et al. Effect of cold-ischemia time on C-X-C chemokine expression and neutrophil accumulation in the graft liver after orthotopic liver transplantation in rats [J]. Transplantation， 2002; 73(11)∶1730.
  6. 6. 　Serracino-Inglott F, Habib NA, Mathie RT. Hepatic ischemia-reperfusion injury [J]. Am J Surg， 2001; 181(2)∶160.
  7. 7. 　Ricciardi R, Kim RD, McDade TP, et al. NF kappa B expression during cold ischemia correlates with postreperfusion graft function [J]. J Surg Res， 2000; 93(1)∶35.
  8. 8. 　Sindram D, Rudiger HA, Upadhya AG, et al. Ischemic preconditioning protects against cold ischemic injury through an oxidative stress dependent mechanism [J]. J Hepatol， 2002; 36(1)∶78.
  9. 9. 　Nilsson B, Friman S, Wallin M, et al. The liver protective effect of ischemic preconditioning may be mediated by adenosine [J]. Transpl Int， 2000; 13 Suppl 1∶S558.
  10. 10. 　Yamamoto Y, Kume M, Yamaoka Y. Implications of heat shock proteins during liver surgery and liver perfusion [J]. Recent Results Cancer Res， 1998; 147∶157.
  11. 11. 　Jiang Y, Gu XP, Qiu YD, et al. Ischemic preconditioning decreases C-X-C chemokine expression and neutrophil accumulation early after liver transplantation in rats [J]. World J Gastroenterol， 2003; 9(9)∶2025.
  12. 12. 　Tsuyama H, Shimizu K, Yoshimoto K, et al. Protective effect of ischemic preconditioning on hepatic ischemia-reperfusion injury in mice [J]. Transplant Proc， 2000; 32(7)∶2310.
  13. 13. 　Ohkita M, Takaoka M, Shiota Y, et al. Nitric oxide inhibits endothelin-1 production through the suppression of nuclear factor kappa B [J]. Clin Sci (Lond)， 2002; 103 Suppl 48∶68S.
  14. 14. 　 Rudiger HA, Clavien PA. A cytotoxic drug against reperfusion injury? [J]. Hepatology， 2000; 31(2)∶533.