肝脏缺血再灌注损伤机制及治疗进展

Mechanism and Treatment Progress of Hepatic Ischemia-Reperfusion Injury

摘要: 1960年，Jennings首先提出缺血再灌注损伤相关概念，即组织器官缺血后再灌注，细胞经历短暂的血供丧失后，组织器官功能不一定恢复，而且组织器官的功能和结构都会受到再次损伤，这种情况在很多重要的组织器官里都会发生。其中，肝脏外科手术中，比如失血性休克和复苏、创伤、肝切除、肝移植等，肝脏缺血再灌注损伤(HIRI)常有发生。HIRI是手术后肝功能障碍、衰竭甚至是死亡的主要原因，它无疑对肝脏外科手术的成功率和预后有极大的负面影响，如何减少HIRI的不良反应对提高肝脏手术成功率至关重要。因此，HIRI一直是近年研究者探索和解决的热门话题之一。但到目前为止，肝的缺血再灌注损伤是临床实践中尚未解决的问题。通过对HIRI的机制和最新的潜在治疗方法进行综述有助于为临床研究与新治疗方法提供思路。

Abstract: In 1960, Jennings proposed the concept of ischemia-reperfusion injury firstly, that is, after ische-mia-reperfusion of tissues and organs, the functions of tissues and organs may not be recovered, and then the functions and structures of tissues and organs will be damaged again, which may hap-pen in many important tissues and organs. Among them, hepatic ischemia-reperfusion injury (HIRI) often occurs during liver surgery, such as hemorrhagic shock and resuscitation, trauma, liver resec-tion, and liver transplantation and so on. HIRI is the main cause of liver dysfunction, failure and even death after surgery, which undoubtedly has a great negative impact on the success rate and prognosis of liver surgery. How to reduce the adverse reactions of HIRI is crucial to improve the success rate of liver surgery. Therefore, HIRI has been one of the hot topics to explore and solve by researchers in recent years. But up to now, liver ischemia-reperfusion injury is an unsolved prob-lem in clinical practice. The mechanism of HIRI and the latest potential treatment methods are re-viewed to provide ideas for clinical research and new treatment methods.