肝动脉重建在小鼠原位肝移植中的作用研究  

Impact of Hepatic Rearterialization on Orthotopic Liver Transplantation in Mice

作　　者：黄德荣[1] 吴忠均[1] 朱宇[1] 

机构地区：[1]重庆医科大学附属第一医院肝胆外科,重庆400016

出　　处：《中国医科大学学报》2009年第12期881-884,共4页Journal of China Medical University

基　　金：国家自然科学基金资助项目(30772055);重庆市卫生局科研项目(06-2-017)

摘　　要：目的探索肝动脉重建在小鼠原位肝移植中的作用。方法以"双袖套法"小鼠肝移植为基础,将带腹主动脉的供肝肝动脉与受体腹主动脉行端侧吻合进行肝动脉重建(实验组),并设立非重建组对照(对照组),分别完成小鼠原位肝移植70例,比较术后48h、1周、1月存活率,肝功能及肝组织病理变化,肝细胞再生、凋亡,炎性介质的表达差异。结果实验组术后1月存活率(88.3%)较对照组(73.3%)明显增加(P<0.05),术后1周实验组血清ALT值[(926.8±36.458)U/L]明显高于对照组[(546.8±74.58)U/L](P<0.01),但术后2周、1月实验组血清ALT值[(88.4±8.336)U/L,66.2±20.512)U/L]较对照组[(179.6±7.536)U/L,156.4±16.041)U/L]明显降低(P<0.01),肝组织病理检查对照组见肝细胞片状坏死、小胆管增生,而实验组肝细胞以变性为主,且术后1月肝组织结构恢复正常;术后对照组肝细胞再生明显增加。结论小鼠原位肝移植中肝动脉重建可明显提高受体长期存活率,促进肝功能恢复,保护肝细胞,明显减少胆道并发症,但对受体移植术后炎性反应无明显影响。Objective To investigate the effects of hepatic artery reconstruction in orthotopic liver transplantation of mice. Methods Following 'double-cuff' liver transplantation in mice,we performed end-to-side anastomosis of the abdominal aorta attached donor hepatic artery with the abdominal aorta of the recipient (experimental group)to set up hepatic artery reconstruction. Meanwhile,non-reconstruction control group (control group)was established. 70 cases of orthotopic liver transplantation in mice were completed and the survival rates at 48 h,1 week and 1 month after the surgery,as well as the hepatic function,histopathological changes,hepatocytes regeneration/apoptosis and expres- sion of inflammatory mediators were compared between these two groups. Results The survival rate of 1-month in experiment group was 88.3%,but in control group was 73.3%,in contrast to control group,reconstructed hepatic artery can raise 1-month survival rate,remarked(P < 0.01).At 1 week postoperatively,the ALT level of experimental group [(926.8±36.458)U/L]was significantly higher than that of control group[(546.8±74.58)U/L,P < 0.01],but at two- and four-week after operation,the ALT level of control group[(179.6±7.536)U/L,156.4± 16.041)U/L]was significantly higher than that of experimental group[(88.4±8.336)U/L,(66.2±20.512)U/L,P < 0.01]. Liver tissue pathology showed necrotic patches of hepatic cells and hyperplasia of small bile ducts in the control group,while in experimental group,hepatic cells mostly underwent degeneration,and hepatic tissue structure returned back to normal at 1 month after the surgery. Postoperative hepatocytes regeneration significantly increased in the control group. Conclusion Hepatic artery reconstruction in mice orthotopic liver transplantation can significantly improve the long-term survival rate of the recipient,promote restoration of liver function,protect hepatocytes and significantly reduce the incidence of biliary complications,but it has no significant impact on inflammatory reaction of the recipien

关 键 词：肝移植 肝动脉重建 胆道并发症 动物模型 小鼠 

分 类 号：R657.3[医药卫生—外科学]