李文川+高良奎+李浩航+韦秋业+杨洁+汪建初+浦涧

【摘要】目的研究左卡尼汀對大鼠肝脏热缺血及再灌注损伤的保护作用，并探讨其相关机制。方法将48只雄性SD大鼠随机分为三组：假手术（SO）组，肝热缺血及再灌注（WIR）组，左卡尼汀预处理（LC）组，各组内再分为再灌注6 h、12 h亚组。LC组腹腔注射左卡尼汀，SO组及WIR组注射等量生理盐水。检测各组血清ALT和AST水平，测定肝组织超氧化物歧化酶（SOD）活性及丙二醛（MDA）含量，观察肝组织病理学改变。结果与SO组比较，WIR组6 h、12 h亚组血清ALT、AST水平均明显高于SO组相同时间点亚组，差异有统计学意义（P<0.01）；与WIR组比较，LC组6 h、12 h亚组血清ALT、AST明显低于WIR组相同时间点亚组，差异有统计学意义（P<0.01）。与SO组比较，WIR组6 h、12 h亚组肝组织匀浆SOD活性均明显低于SO组相同时间点亚组，差异有统计学意义（P<0.01）；WIR组6 h、12 h亚组肝组织匀浆MDA含量均明显高于SO组相同时间点亚组，差异有统计学意义（P<0.01）；与WIR组比较，LC组6 h、12 h亚组肝组织匀浆SOD活性均明显高于WIR组相同时间点亚组，差异有统计学意义（P<0.01），LC组6 h、12 h亚组肝组织匀浆MDA含量均明显低于WIR组相同时间点亚组，差异有统计学意义（P<0.01）。结论左卡尼汀对大鼠肝脏热缺血及再灌注损伤具有保护作用，其机制与提高抗氧化防御系统和脂质过氧化反应有关。

【关键词】左卡尼汀；肝热缺血及再灌注损伤；保护作用

中图分类号：R657.3文献标识码：ADOI：10.3969/j.issn.10031383.2016.05.004

【Abstract】ObjectiveTo investigate the protective effects of LCarnitine on liver warm ischemia and reperfusion injury （WIRI） in rats，and to explore its possible mechanism.MethodsFortyeight male SpragueDawley（SD） rats were randomly divided into the following three groups：Shamoperated（SO）group，liver warm ischemia and reperfusion（WIR） group and LCarnitine pretreatment（LC）group.Within each group，rats were divided into reperfusion 6h and 12h subgroups.LCarnitine was injected through abdominal cavity in LC group while the equal volume of saline was injected in SO group and WIR group.And then，the levels of serum Alanine aminotransferase（ALT） and Aspartate aminotransferase（AST） as well as the activities of Superoxide dismutase（SOD） and the content of Malondialdehyde（MDA） in liver tissues were detected.Meanwhile，pathological change of liver tissue was observed.ResultsCompared with the SO group，serum ALT and AST levels of 6h and 12h subgroups in the WIR group at the same time point were significantly higher，difference was statistically significant（P<0.01）；Compared with the WIR group，serum ALT and AST levels of 6h and 12h subgroups in the LC group at the same time point were significantly lower，difference was statistically significant（P<0.01）.Compared with the SO group，SOD activities of liver homogenate of 6h and 12h subgroups in the WIR group at the same time point were obviously lower，difference was statistically significant（P<0.01），while the content of MDA was significantly higher，difference was statistically significant（P<0.01）.In addition，SOD activities of liver homogenate of 6h and 12h subgroups in the LC group at the same time point were obviously higher than those of the WIR group，difference was statistically significant（P<0.01），while the content of MDA was significantly lower，difference was statistically significant（P<0.01）.ConclusionLCarnitine has protective effects on WIRI in rats，its mechanism may be related with improvement of the antioxidant defense system and lipid peroxidation levels.

【Key words】LCarnitine；WIRI；protective effects

肝臟热缺血及再灌注损伤（warm ischemia and reperfusion injury，WIRI）是肝脏手术中多因素且复杂的病理生理过程，其显著影响疾病的预后、手术成功率及患者的生存[1]。左卡尼汀（Lcarnitine，LC）在平衡抗氧化系统过程中扮演着重要角色，并具有抗过氧化的效果[2]。近年研究报道左卡尼汀在肾缺血再灌注损伤中具有明显保护作用[3]，但其在肝脏WIRI中的作用研究较少。本研究建立大鼠肝脏热缺血及再灌注损伤模型，观察肝功能、肝组织病理学改变及超氧化物歧化酶（Superoxide Dismutase，SOD）、丙二醛（Malondialdehyde，MDA）的变化，探讨左卡尼汀对大鼠肝脏WIRI的保护作用及其机制。

1材料与方法1.1材料与试剂SPF级雄性SpragueDawley（SD）大鼠48只，体重240～270 g，由右江民族医学院动物中心（许可证号：SCXK桂2012-0003）提供；左卡尼汀注射液购自常州兰陵制药有限公司；组织总超氧化物歧化酶（TSOD）、MDA测试盒购自南京建成生物工程研究所；石蜡切片机（德国HM 315）；……