中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (18): 3231-3234.doi: 10.3969/j.issn.1673-8225.2011.18.001

• 肝移植 liver transplantation •    下一篇

多参数系统生物传感器Neurotrend-7监测移植早期肝细胞的代谢

唐继红1，唐  波1，张  捷1，杨达宽1，田大广1，付必莽1，李晗宇2，余胜锋1，朱  洪1   

  1. 1昆明医学院第二附属医院肝胆胰外科，昆明医学院第二附属医院肝胆胰研究所，云南省昆明市650101
    2云南省第二人民医院，云南省昆明市650101
  • 收稿日期:2010-11-01 修回日期:2010-12-21 出版日期:2011-04-30 发布日期:2011-04-30
  • 通讯作者: 朱洪，博士，副教授，昆明医学院第二附属医院肝胆胰外科，云南省昆明市 650101 并列通讯作者：张捷，硕士，教授，博士生导师，昆明医学院第二附属医院肝胆胰外科，云南省昆明市，650101 zhangjie@public.km.yn.cn
  • 作者简介:唐继红，男，1966年生，云南省大理市人，汉族，1990中山医科大学毕业，主要从事肝胆胰外科及肝移植临床及基础研究工作。 tangbo1227@163.com
  • 基金资助:

    昆明医学院-云南省科技厅联合专项基金资助项目(2007C0011R)。课题名称：肝移植术后早期持续肝功能监测的实验和临床应用研究。

Monitoring of liver cell metabolism in early transplantation with the multi parameter system biosensor Neurotrend-7

Tang Ji-hong1, Tang Bo1, Zhang Jie1, Yang Da-kuan1, Tian Da-guang1, Fu Bi-mang1, Li Han-yu2, Yu Sheng-feng1, Zhu Hong1   

  1. 1Department of Hepatobiliary-pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, the Institute of Hepatobiliary- Pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, Kunming  650101, Yunnan Province, China
    2the Second People’s Hospital of Yunnan Province, Kunming  650101, Yunnan Province, China
  • Received:2010-11-01 Revised:2010-12-21 Online:2011-04-30 Published:2011-04-30
  • Contact: Zhu Hong, Doctor, Associate professor, Department of Hepatobiliary-pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, Kunming 650101, Yunnan Province, China Correspondence to: Zhang Jie, Master, Professor, Doctoral supervisor, Department of Hepatobiliary-pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, Kunming 650101, Yunnan Province, China zhangjie@public.km.yn.cn
  • About author:Tang Ji-hong, Department of Hepatobiliary-pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, the Institute of Hepatobiliary- pancreatic Surgery, Second Affiliated Hospital of Kunming Medical College, Kunming 650101, Yunnan Province, China tangbo1227@163.com
  • Supported by:

    Fund of Kunming Medical College United Yunnan Provincial Technology Commission, No. 2007C0011R*

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摘要：

背景：目前，各种监测设备已经用于移植肝的早期监测，但没有一种方法能够持续不断的监测移植肝细胞的代谢变化来反映移植肝内部环境的变化情况。
目的：探讨应用多参数系统生物传感器Neurotrend-7持续监测肝细胞代谢，为早期发现移植后肝脏功能不良提供依据。
方法：健康成年雄性日本大耳白兔24只分为3组，对照组(n=4)：开腹仅行肝组织埋入氧代谢监测传感器及标本取材后关腹。两个实验组完成兔肝移植后肝内置入多参数监测仪传感器探针，实验1组(n=10)供肝保存时间< 2 h；实验2组(n=4)供肝保存时间> 4 h。移植前及移植后1，3，5 d连续监测肝组织的pH、氧分压、二氧化碳分压变化并测量动脉血PaO2、PaCO2、动脉血气pH值。同时，切取同位点的肝组织行光镜和电镜检查。
结果与结论：实验2组肝组织氧分压显著低于实验1组(P < 0.05)，且随时间逐渐下降；肝组织二氧化碳分压各时段高于实验1组(P < 0.05)，并且随时间逐渐增高；肝组织pH值较实验1组各时间段更低(P < 0.05)，提示肝功能严重不良或移植肝无功能。肝组织氧分压与动脉血PaO2呈正相关，肝组织二氧化碳分压与动脉血PaCO2无明显相关性；肝组织pH与动脉血气pH值也无明显相关性。变化与组织学检查相似。提示，多参数系统生物传感器Neurotrend-7可为早期发现移植后肝脏功能不良，观察其演变规律，指导临床早期预防和治疗，为其在肝脏外科和器官移植领域临床应用提供准确的数据支持。

关键词: 多参数系统生物传感器, 肝移植, 移植物原发无功能, 肝细胞代谢, 氧分压, 二氧化碳分压, pH值

Abstract:

BACKGROUND: At present, various monitoring equipments have been used in graft early monitoring, but there is no way to continuous monitoring transplant liver cell metabolic changes to reflect the graft internal environment changes.
OBJECTIVE: To explore continuous monitoring of liver cell metabolism with multi parameter system biosensor (Neurotrend-7), and to provide the basis for the liver hypofunction after transplantation in early stage.
METHODS: A total of 24 healthy, adult, male, New Zealand, White rabbits were divided into 3 groups: control group, experimental group 1, and experimental group 2. Control group (n=4): They were treated with buried oxygen metabolism monitoring sensor of liver tissue when abdomen was opened, and abdomen was closed, after the specimen drawn. Multi parameter system biosensor probe was inserted into liver after liver transplantation between experimental group 1 and experimental group 2. Ten cases of rabbits underwent the liver transplantation, for the liver retention time was lesser than 2 hours in experimental group 1; 4 cases of rabbits underwent the liver transplantation, for the liver retention time was more than 4 hours in experimental group 2. Before transplantation and 1, 3, 5 days after transplantation, the changes of the pH, PCO2, and PO2 value in liver tissue were continually monitored, and PaO2, PaCO2, and arterial blood gas (ABG) pH value were measured. At the same time, the liver tissue cut in the corresponding points was observed under the optical microscope and electron microscope.
RESULTS AND CONCLUSION: PO2 value of liver tissue in experimental group 2 was significantly lower than that in experimental group 1 (P < 0.05), and gradually decreased with the time. However, PCO2 value of liver tissue in experimental group 2 at each time was significantly higher than that in experimental group 1 (P < 0.05), and gradually increased with the time. pH value of liver tissue in experimental group 2 at each time was lower than that in experimental group 1 (P < 0.05). It is indicated that liver function is serious adverse and transplant is non-function. The PO2 and PaO2 were positive correlation; however, PCO2 and PaCO2 were not obvious relevance. Also, the pH value and ABG pH value were not obvious relevance. Changes are similar to the histology inspection. It suggested that multi parameter system biosensor (Neurotrend-7) can discover liver hypofunction after transplantation at early stage and observes its evolution rule, to guide early prevention and the treatment in clinic, it also can provides the accurate data for clinical application in the liver surgery and organ transplantation field.

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