毕业论文 作者：阚彤 杨甲梅 严以群 吴孟超
【关键词】 前列腺素E1； 肾功能； 肝移植； 大鼠
Protective effect of prostaglandin E1 on renal function of rats after liver transplantation
【Abstract】 Objective To assess the protective effect of prostaglandin E1 (PGE
1) on renal function of rats after liver transplantation. Methods PGE1 treatment group was established by infusing PGE1 into internal jugular vein at 0.5 μg/(kg·min) during liver transplantation. Normal saline group and sham operation group were established as control. Oneweek survival rates were observed and urinary output 1 hour after liver reperfusion was recorded. Postoperative plasma creatinine (CRE) and urea nitrogen (UN) were determined every day during the first week. The levels of glutathione (GSH) and malondialdehyde (MDA) in kidney tissues were measured to assess ROI injury. Kidney tissue sections were stained with hematoxylin and eosin for histological examination. Results Compared with the control groups, the urinary output 1 hour after liver transplantation in PGE1 group increased significantly, while the levels of CRE and UN decreased; the levels of GSH in kidney tissues in PGE1 group were significantly higher than those in control group, while the MDA was comparatively lower. Histological examination of kidney demonstrated beneficial effects of PGE1 on nephric tubule. Conclusions Application of PGE1 during operation can promote the renal function of rats after liver transplantation, which may be related to the resistance of injury from oxygen free radical.
【Key words】 Prostaglandin E1; Renal function; Liver transplantation; Rats
肝移植术后肾功能损害是导致肝移植失败的重要原因之1。任何能够减轻肝移植术中肾功能损害的药物和手段都有重要意义。本研究旨在进1步探讨术中应用前列腺素E1(prostaglandin E1,PGE
1)对大鼠肝移植术后肾功能的保护作用，为临床应用提供理论依据。
1 材料与方法
1.1 实验动物及分组
雄性Wistar近交系大鼠，由中国科学院上海实验动物中心提供。体质量200～220 g为供体，220～250g为受体。供体组与受体组大鼠随机配对后分为PGE1治疗组、生理盐水和空白对照组，每组13对，8对用于观察生存率和取血生化检测；5对用于急性期实验，组织标本取材。PGE1治疗组受体术中经颈内静脉插管滴注PGE1［0.5 μg/(kg·min)］；生理盐水对照组大鼠术中经颈内静脉插管滴注生理盐水，滴注速率均为50 μl/min。空白对照组经颈内静脉插管后不滴注任何液体，术毕经阴茎背静脉注射生理盐水1.5～3.0 ml。
1.3 仪器
微电脑输液泵(WE50c)购自浙江医科大学；全自动生化分析仪(7710A)购自日本日立公司；低温离心机(ZK
1
5)购自美国Sigma公司。
1.4 移植手术
供体手术和供肝修整参照1979年Kamada等介绍的方法。肝上下腔静脉吻合参照1996年严以群等报道的改良Kamada术式，采用1针连续缝合法。右侧颈内静脉插管，连接到微电脑输液泵。滴注开始立即阻断下腔静脉和门静脉，进入无肝期，于无肝期10 min时开始植入肝脏。供肝植入后无肝期时间达到30 min时再开放门静脉血流，结束无肝期。
1.5 标本采集和测定
1.6 统计学分析
计数资料应用χ2检验，计量资料数据以±s表示。各组间以StudentNewmanKeuls检验作比较。P<0.05为差异有统计学意义。
2 结果
2.1 大鼠肝移植术后1周生存率
空白对照组有5例存活超过1周，生理盐水对照组有7例存活超过1周，PGE1治疗组全部长期存活。
2.2 血浆尿素氮
2.3 血浆肌酐
2.4 移植肝再灌注后1 h尿量
2.5 肾组织氧自由基检测结果
2.6 病理检查
3 讨论
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参考文献
】［2］Klein AS, Cofer JB, Pruett TL, et al. Prostaglandin E1 administration following orthotopic liver transplantation: a randomized prospective multicenter trial. Gastroenterology,1996,111
(3):710-715.
［6］Hariharan S, McBride MA, Cherikh WS, et al. Posttransplant renal function in the first year predicts longterm kidney transplant survival. Kidney Int,2002,62
(1):311-318.
