中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8211-8214.doi: 10.3969/j.issn.1673-8225.2010.44.011

• 细胞与组织移植 cell and tissue transplantation • 上一篇    下一篇

不同缺血后处理方法对大鼠胰腺移植的保护作用及其机制

张召辉1，王为忠2，李  玺1，牛万成1，陈党英1，张云民1   

  1. 1解放军97中心医院普通外科，徐州医学院附院普通外科，江苏省徐州市  221004；  2解放军第四军医大学西京医院胃肠外科，陕西省西安市  710032
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 作者简介:张召辉☆，男，1972年生，安徽省灵璧县人，汉族，2008年解放军第四军医大学毕业，博士，副主任医师，主要从事胃肠外科及器官移植的研究。 zzhlyn@163.com

Protective effects and mechanism of different ischemic postconditionings for rat pancreas after transplantation

Zhang Zhao-hui1, Wang Wei-zhong2, Li Xi1, Niu Wan-cheng1, Chen Dang-ying1, Zhang Yun-min1   

  1. 1 Department of General Surgery, the 97 Hospital of Chinese PLA, Department of General Surgery, Hospital Affiliated to Xuzhou Medical College, Xuzhou  221004, Jiangsu Province, China; 2 Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA, Xi’an  710032, Shaanxi Province, China
  • Online:2010-10-29 Published:2010-10-29
  • About author:Zhang Zhao-hui☆, Doctor, Associate chief physician, Department of General Surgery, the 97 Hospital of Chinese PLA, Department of General Surgery, Hospital Affiliated to Xuzhou Medical College, Xuzhou 221004, Jiangsu Province, China zzhlyn@163.com

PDF

344

摘要：

背景：缺血-再灌注损伤是胰腺移植后血栓形成和急性胰腺炎的主要原因之一，又是胰腺移植中不可避免的过程，会严重影响移植胰腺的功能。如何减轻缺血-再灌注损伤是目前移植外科的研究热点之一。
目的：观察不同缺血后处理方法对大鼠移植胰腺冷缺血再灌注损伤的保护作用。
方法：48只糖尿病SD大鼠随机数字表法分为为4组，对照组，缺血后处理1组(再灌注30 s缺血30 s 1次)，缺血后处理2组(再灌注30 s/缺血30 s 3次)和缺血后处理3组(再灌注30 s/缺血30 s 6次)，各组均行胰腺移植；48只建康SD大鼠为供体；检测各组大鼠再灌注前后血糖，再灌注后2 h移植胰腺组织中超氧化物歧化酶、丙二醛及髓过氧化物酶变化，TUNEL法检测移植胰腺组织细胞凋亡情况。
结果与结论：再灌注后缺血后处理组较对照组血糖降低(P < 0.01)；缺血后处理2组较缺血后处理1组和缺血后处理3组血糖低(P < 0.05)；再灌注后缺血后处理组较对照组移植胰腺组织中超氧化物歧化酶水平高(P < 0.01)，丙二醛及髓过氧化物酶水平低(P < 0.01)，缺血后处理2组较缺血后处理1组和缺血后处理3组超氧化物歧化酶水平高(P < 0.05)、丙二醛及髓过氧化物酶水平低(P < 0.05)。再灌注后缺血后处理组较对照组移植胰组织中细胞凋亡指数值低(P < 0.01)，缺血后处理2组较缺血后处理1组和缺血后处理3组细胞凋亡指数值低(P < 0.05)，提示缺血后处理对大鼠移植胰腺的缺血再灌注损伤具有保护作用，并可以减少移植胰腺缺血再灌注后的细胞凋亡，再灌注30 s/缺血30 s循环3次是最佳的大鼠移植胰缺血后处理诱导办法。

关键词: 胰腺移植, 缺血后处理, 缺血再灌注, 细胞凋亡, 大鼠

Abstract:

BACKGROUND: Ischemia/reperfusion injury is one of main reasons of thrombosis and acute pancreatitis following pancreatic transplantation, and is the unavoidable process of pancreatic transplantation, finally results in affecting the function of transplanted pancreas. How to relieve ischemia/reperfusion injury is a hot point of transplantation surgery at present.
OBJECTIVE: To evaluate the protective effects of different ways of ischemic postconditioning on ischemia/reperfusion injury in rat pancreas after transplantation.
METHODS: A total of 48 diabetic Sprague Dawley rats were randomly assigned to four groups: control group (C，n=12), ischemic postconditioning 1 group (30-second reperfusion followed by 30-second ischemia once), ischemic postconditioning 2 group (30-second reperfusion followed by 30-second ischemia thrice), and ischemic postconditioning 3 group (30-second reperfusion followed by 30-second ischemia six times). All groups received pancreas transplantation. A total of 48 healthy Sprague Dawley rats served as donors. The blood glucose pre- and post-reperfusion, malondialdehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO) changes at 2 hours postreperfusion were detected in the pancreatic tissue in each group. Apoptotic cells in graft were monitored by TUNEL assay.
RESULTS AND CONCLUSION: Glucose levels were decreased in the ischemic postconditioning groups compared with control group following ischemia/reperfusion group (P < 0.01). Glucose levels were lower in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group (P < 0.05). The SOD levels were greater (P < 0.01), but MDA and MPO levels were lower (P < 0.01) in the ischemic postconditioning groups compared with control group following ischemia/reperfusion. SOD levels were greater (P < 0.05), but MDA and MPO levels were lower (P < 0.05) in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group. Apoptotic index was low in the ischemic postconditioning groups compared with control group following reperfusion (P < 0.01). Apoptotic index was lower in the ischemic postconditioning 2 group compared with ischemic postconditioning 1 group and ischemic postconditioning 3 group (P < 0.05). These indicated that ischemic postconditioning can protect graft from ischemia/reperfusioin injury and reduce apoptosis of the graft during pancreas transplantation. Three cycles of 30-seconds ischemia and 30-seconds reperfusion are the best way to induce ischemic preconditioning in rat pancreas transplantation.

中图分类号: