| 黄疸肝における虚血 : 再潅流時の病態とその対策. Pathology and Treatment of Ischemia-Reperfusion Injury in the Rat Obstructive Jaundiced Liver | |||||||||||||
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| 閉塞性黄疸を合併する肝切除術においては, 術後肝不全に難渋することも少なくない。そこでラット閉塞性黄疸肝モデルを用いて, 手術の際問題となる, 虚血再潅流障害の閉塞性黄疸肝における病態の解明とその対策について検討した。閉塞性黄疸肝モデルは, 総胆管を結紮切離して作製した。経日的検討では, s-ALTは上昇し, 肝蛋白合成能は低下した。肝組織SOD活性, 肝組織MDA, 活性酸素産性能は上昇した。60分肝虚血再潅流モデルでの検討では, 閉塞性黄疸群の血流再開後90分の肝組織血流量は低下し, s-ALT, 肝組織MDAは高値になった。閉塞性黄疸肝は蛋白合成能の低下, 活性酸素による肝細胞膜障害が進行する状態であり, 虚血再潅流障害においては, 防御機能が低下していることが示唆された。そこで, 所らの検討にて, 肝虚血再潅流障害に有効であったβ1-3glucanを投与したところ, 経日的検討では, 肝組織MDAの上昇が抑えられ, 虚血再潅流モデルでの検討でも, 肝組織MDAが抑制された。β1-3glucanが閉塞性黄疸肝障害, 閉塞性黄疸肝虚血再潅流障害を, ある程度軽減できる可能性が示唆された。. When hepatectomy is performed for patients with obstructive jaundice, postoperative liver failure develops in many cases. In this study, we clarified ischemia-reperfusion injury, which is considered an intraoperative issue, in the liver with obstructive jaundice using a rat obstructive jaundice liver model, and examined the strategies. An obstructive jaundice liver model was prepared by ligation of common bile duct. When serial changes were examined, the level of s-ALT was increased, while HPS was decreased. Hepatic tissue SOD activity, hepatic tissue MDA and active oxygen-producing capacity were increased. In the model that underwent reperfusion after hepatic ischemia for 60 minutes, HTBF in the group with obstructive jaundice was reduced 90 minutes after reperfusion. Levels of s-ALT and hepatic tissue MDA were increased. In the liver with obstructive jaundice, HPS was reduced, while hepatic cellular membrane disorder related to active oxygen was exacerbated. It was suggested that ischemia-reperfusion injury reduced the protective function. Therefore, β1-3glucan, which was effective for ischemia-reperfusion injury in our previous experiment, was administered. When serial changes were examined, an increase in hepatic tissue MDA was inhibited. In the reperfusion model, hepatic tissue MDA was also inhibited. It was suggested that β1-3glucan relived hepatopathy with obstructive jaundice and ischemia-reperfusion injury in the liver with obstructive jaundice to some degree. | |||||||||||||
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