目的:探讨野黄苓甙在大鼠体外肝脏灌流复苏无心跳边缘供肝过程中对供肝功能和超微结构的影响.方法:采用清洁级雄性Wistar大鼠24只,无心跳供肝按热缺血时间和处理方法的不同随机分为3组.A组(n=8)无心跳供肝的热缺血时间在安全时限内(15～20 min),B组(n=8)和C组(n=8)无心跳供肝的热缺血时间均为45 min;3组均采用体外肝脏灌流系统(ECLP)常温灌流6 h,其中C组在灌流液中定时加入定量的野黄芩甙溶液.观察灌流后1 h、3 h和6 h供肝胆汁分泌量的变化以及灌流液中丙氨酸氨基转移酶(ALT)和内皮素-1(ET-1)水平的变化;在灌流前和灌流后1 h、3 h和6 h分别取3组供肝标本,通过透射电镜观察肝细胞超微结构的变化.结果:B、C 2组供肝在灌流后1 h和3 h胆汁分泌量与A组相比差异显著(P<0.05),但随着灌流时间的延长,在灌流后6 h 3组差异不显著(P>0.05),灌流后3 h B和C组差异显著(P<0.05).灌流液中ALT 和ET-1的水平在3个时点B组、C组与A组相比差异有统计学意义(P<0.05),B组和C组在灌流后3 h和6 h差异显著(P<0.05),但在灌流后1 h差异不显著(P>0.05).超微病理变化显示灌注前与A组相比,B、C 2组供肝的肝细胞线粒体部分膜断裂,嵴疏松溶解,核皱缩变形,染色质粗糙,核仁浓缩甚至裂解.灌流3 h后B、C 2组供肝的超微结构均有明显的恢复,灌流6 h后C组肝细胞结构恢复得更加明显.结论:体外肝脏灌流野黄苓甙能够改善无心跳边缘供肝的功能和超微结构.%AIM: To investigale the effect of scutellarin on resuscilaling rat non - heart - healing marginal donor (NHBMD) livers with exlracorporeal liver perfusion in vitro. METHODS; Twenly -four male Wislar rats were randomly divided into 3 groups; group A (n = 8) , the livers were subjecl Lo 15 ~20 min of warm ischemia; group B (n = 8) and group C ( n = 8 ) , the livers were suhjecl lo 45 min of warm ischemia. All the livers were trealed hy exlracorporeal liver perfusion (ECLP) , and sculellarin solution was add lo the perfusion fluid in group C wilh the intervals of 1 h. The data of bile production and the markers of hepalocyle reperfusion injury of the livers,alanine aminolransferase ( ALT) and endolhe-lin - 1 (ET - 1) , in each group were tesled. The liver tissues in each group were oblained before perfusion and 1 h, 3 h and 6 h after perfusion, and then observed under transmission electron microscope lo investigale the changes of ullrastruc- Lures. RESULTS; With the Lime of perfusion wenL on, the livers in group B and group C demonsLraLed recovery of synLhe-tic function afLer 3 h and 6 h of perfusion, and Lhe production of bile in group B and group C was noL significantly differenL from that in group A after 6 h of perfusion ( P > 0. 05 ) . The levels of ALT and ET - 1 in group B and group C were significantly higher than those in group A after 1 h, 3 h and 6 h of perfusion ( P < 0. 05 ) , and those in group C was significantly lower than those in group B after 3 h and 6 h of perfusion ( P < 0. 05 ) . The ultrasLrucLural destruction of the liver cells in both group B and group C was more serious than that in group A. After 3 h and 6 h of perfusion, the destruction of the liver cells was partly recovered, and the recovery degree in group C was more obvious than that in group B. CONCLUSION; Scutellarin may play a significant role in resuscitating rat NHBMD livers with extracorporeal liver perfusion in vitro.
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