The Influence Of Limb Ischemic Preconditioning For Hepatic Ischemia/reperfusion Injury Of The Liver Cirrhosis Rabbits

[Objective] Hepatic ischemia/reperfusion injury(HIRI) is one of the reasons that cause postoperative liver failure or transplanted liver no function. Patients with resection of liver cancer or liver transplant surgery are always accompanied with liver cirrhosis. So how to prevent hepatic ischemia/reperfusion injury is hot and difficult in current research. In this study, we discuss the influence of the preoperative limb ischemic preconditioning (LIPC) to hepatic ischemia/reperfusion injury on the liver cirrhosis rabbits.[Methods]1.Modeling and groupingThirty-two New Zealand rabbits were injected with50%CCL4-olive oil to make liver cirrhosis model. Two rabbits died of acute poisoning of CCL4. Twelve weeks later, choose two rabbits randomly and take a portion of the liver to investigate the pathological changes of the liver cirrhosis. Twenty-eight rabbits were randomly divided into four groups(seven rabbits per group):sham group(S group)、ischemia/reperfusion group(I/R group)、ischemic preconditioning group(IPC group)、limb ischemic preconditioning group(LIPC group).2. InterventionSham group(S group):Separate the hepatic pedicle in laparotomy, no any other treats, the open time is2.5h.Ischemia/reperfusion group(I/R group):Separate the hepatic pedicle in laparotomy, inflow occlusion30min, open2h.Ischemic preconditioning group(IPC group):Separate the hepatic pedicle in laparotomy, Inflow occlusion10min and then open10min, inflow occlusion30min open2h.Limb ischemic preconditioning group(LIPC group):24h ago, before operative use a tourniquet to hinder the artery on the rabbits leg5min, then relieve for5min,3times for all. Separate the hepatic pedicle in laparotomy, inflow occlusion30min, open2h.3. Indicators detectionDetect ALT、AST in the serum and ALT、AST、MDA、SOD、ET-1、TNF-α levels in the liver tissue.[Results]1.Liver pathological injury in I/R group、IPC group、LIPC group was serious than S group, comparing to I/R group, the pathological changes of IPC group and LIPC group was not as serious as I/R group,and the LIPC and IPC group showed the same pathological changes in some degree.2. Comparing to Sham group, the levels of the ALT、AST、MDA、ET-1、TNF-α were significantly higher. Comparing to I/R group, the levels of the ALT、AST、MDA、ET-1、TNF-α in IPC group and LIPC group was not as serious as I/R group, and the ALT、AST、MDA、ET-1、 TNF-a between IPC group and LIPC group showed no difference.[Conclusions] This study confirmed the limb ischemic preconditioning alleviate cirrhosis hepatic ischemia-reperfusion injury in rabbits. At present, the mechanism of protective effect of limb ischemic preconditioning is still not too clear. This study showed that the mechanism may be related to increasing the activity of SOD, decreasing oxygen free radicals, decreasing the release of ET-1, improving the liver microcirculation, reducing the release of TNF-α.