摘要目的 探讨奥曲肽在兔肝缺血再灌注后对远处器官肺损伤的影响.方法 采用Pring's兔肝脏再灌注模型,将24只新西兰大白兔随机分为三组:Ⅰ组(假手术组)、Ⅱ组(肝脏缺血再灌注生理盐水组)、Ⅲ组(奥曲肽预适应组).Ⅲ组于腹腔内注射20μg/kg奥曲肽和皮下注射30μg/kg奥曲肽,均用0.9%的生理盐水稀释至2 ml,其他组在同一时间点用同样途径注射等量生理盐水.观察三组动物肝门阻断前(T1)、阻断后30 min(T2)、再灌注后30 min(Ts)、60 min(T4)、120 min(T5)、240min(T6)平均动脉压和心率的变化,以及T1、T2、T3、T4、T5、T6各时间点肿瘤坏死因子α(TNF-α)和白介素-1β(IL-1β)的变化,再灌注后240rain时处死兔子,取肺组织在透射电镜下观察各组肺细胞超微结构的变化,采用TUNEL法检测其凋亡细胞.结果 MAP和HR在T2至T4时间点Ⅱ组、Ⅲ组明显低于Ⅰ组,而Ⅱ组显著低于Ⅲ组(P<0.05);Ⅱ组从T2开始、Ⅲ组从T3开始两组血浆TNF-α、IL-β显著高于Ⅰ组(P<0.05),且Ⅲ组从T2开始后各时点血浆TNF-α和IL-β明显低于Ⅱ组(P<0.01);透射电镜下Ⅲ组肺的亚细胞结构损伤显著轻于Ⅱ组,采用TUNEL法检测肺组织中的凋亡细胞数在5个高倍镜下Ⅱ组(55.82±4.19)、Ⅲ组(32.17±3.10)明显多于Ⅰ组(3.96±0.87),而Ⅲ组显著少于Ⅱ组(P<0.01).结论 奥曲肽对于兔肝缺血再灌注后远处器官肺的损伤确有保护作用.

abstractsObjective To research the effect of octreotide on the lung injury of far place organ after ischemia-reperfusion in rabbit liver.Methods Prings maneuver rabbit hepatic ischemia-reperfusion models were established. 24 adult New Zealand rabbits were random divided into three groups: group Ⅰ (sham operative group) , group Ⅱ (ischemia-reperfusion by physiological saline group) and group Ⅲ (octreotide preconditioning group). To group Ⅲ, we injected octreotide of 20μg/kg to abdominal cavity and octreotide of 30(μg/kg to skin following, and octreotide was dissolved into 2ml with 0. 9% physiological saline. To group Ⅰ and Ⅱ, octreotide were replaced with the same amount of physiological saline. The changes of MAP, HR in every group were recorded at the time before ischemia (T1 ) , 30min (T2) after ischemia, 30min(T3) , 60min(T4) , 120min(T5) , 240min(T6) after reperfusion. The tumor necrosis factor-alpha (TNF-a) and interleukin-lbeta (IL-1β) in the plasma in every group at T1, T2, T3, T4 , T5, T6 were detected. These rabbits were killed 240 min after reperfusion, then the lung's hepatocellular ultrastructures of every group were observed under electromicroscope, and the apoptosis of lung was detected by TUNEL. Results The MAP, HR of group Ⅱ and group Ⅲ were lower than that of group Ⅰ at T2 to T4. Moreover, group Ⅱ were lower than that of group Ⅲ (P <0.05). The TNF-a, IL-1β of group Ⅱ (fromT2) and group Ⅲ ( from T3) were higher than that of group Ⅰ ( P < 0.05) , and group Ⅲ were lower than group Ⅱ after ischemia (P <0. 01). Through electromicroscope, we found that the injury of the lungs hepatocellular ultrastructure in group Ⅲ was slighter than that in group Ⅱ . We detected the apoptosis of the lung organizes by TUNEL under 5 fields of light microscopes, and found that the apoptosis counts of group Ⅱ (55. 82 ±4. 19) and group Ⅲ (32. 17 ±3. 10) were more than that of group Ⅰ (3. 96 ±0. 87), and group Ⅲ were less than thatof group Ⅱ (P < 0. 01). Conclusion Octreotide can protect the lung injury of far place organ after ische-mia-reperfusion in rabbit liver.