【作者】 冯敏；

【导师】 张培建； 刘歆农；

【作者基本信息】 扬州大学 ， 外科学， 2008， 硕士

【摘要】 一、目的及意义缺血再灌注损伤存在于许多疾病和手术过程当中。在肝脏移植手术后,引起移植物原发性无功能,缺血再灌注损伤是常见原因之一。经过几十年的发展,医学工作者发现了多种减轻缺血再灌注损伤的有效方法。其中在肝移植手术中,采用去铁敏行药物预适应,目前还未见类似报道。本研究采用去铁敏对手术大鼠行预适应处理,观察去铁敏是否对移植供肝存在保护作用,同时和低氧预处理进行对比,比较两种预处理方法的作用特点。二、方法为了更精确的研究肝移植过程中的缺血再灌注损伤,本实验采用大鼠自体肝移植模型。此模型避免了同种异体原位肝移植模型免疫损伤的影响,同时又可以精确控制缺血时间。本实验首先通过对比去铁敏(全身)预处理组(术前腹腔注射去铁敏)与对照组(只做自体肝移植手术,不作任何预处理),观察去铁敏是否对移植供肝有保护作用。再进一步实验对比去铁敏(全身)预处理组与去铁敏局部处理组(自体肝移植术中采用去铁敏溶液灌肝),观察两种不同给药方法的保护效果。如果,研究结果显示,去铁敏对供肝存在保护作用,继续做进一步研究。对比去铁敏预处理组与低氧预处理组,观察去铁敏对移植供肝有保护作用的特点。三、结果研究结果显示,去铁敏对供肝存在保护作用并且去铁敏(全身)预处理的保护作用明显强于去铁敏局部处理;进一步实验结果表明去铁敏预处理与低氧预处理无明显差异,都对移植供肝存在良好的保护作用。四、结论本次实验将去铁敏预处理与低氧预处理在肝脏移植中的保护作用进行比较,进一步探讨了低氧预处理在肝脏移植中减轻缺血再灌注损伤的机制,以期能够用去铁敏预处理替代低氧预处理,去铁敏预处理将更易于与临床相结合,为降低肝脏移植术后原发性移植肝无功能,提高移植肝脏的质量,延长患者生存时间和生存质量提供参考。更多还原

【Abstract】 【objective】: Several diseases and operations can result in ischemical reperfusion injure. Liver transplantation is an case in point. Ischemical reperfusion injure can cause transplanted liver dysfunction so several decades years have witnessed the development of methods to relieve ischemical reperfusion injure. Deferoxamine preconditioning has been practiced in other tissues and organs but hasn’t been used in liver transplantation. The objective of this thesis is to research the effect of deferoxamine on transplanted liver. At the same time, compare the protection effect on graft between deferoxamine and hypoxia, which has been found could protect transplanted liver in our finished research, and explode the distinction of deferoxamine’s protection effect.【methods】: We use analogic liver transplantation model in our research for better studying ischemical reperfusion injure. Because this model can expel immune injure in orthotopic liver transplantation and we can control liver’s ischemia time in analogic liver transplantation, which can benefit for comparing among each groups. We begin our research with contrasting deferoxamine preconditioning group to analogic liver transplantation group. In former group, we give each rat deferoxamine 300mg/Kg via intraperitoneal injection 24hours and 48hours before operation. In later group, we don’t give each rat any preconditioning around operation. By this experiment, we can find whether deferoxamine preconditioning can protect transplanted liver or not. Moreover, we contrast deferoxamine local preconditioning to deferoxamine systematic preconditioning and research the effect of different administration route. At last, compare the protection effect of deferoxamine and hypoxia to explode a new transplanted liver protection method which is more suitable for clinic practice. 【results】: Results of our research indicate that deferoxamine preconditioning can protect transplanted liver as same as hypoxia preconditioning. Further study indicates that deferoxamine systematic preconditioning can provide the better protection to transplanted liver than deferoxamine local preconditioning.【conclusions】: Deferoxamine systematic preconditioning can protect transplanted liver as same as hypoxia preconditioning, which can relieve ischemical reperfusion injure in liver transplantation and prevent graft dysfunction after transplantation. However, deferoxamine systematic preconditioning is a kind of drug preconditioning, which is suitable for clinic practice contrasting to hypoxia preconditioning.更多还原