入肝门静脉动脉化对肝部分切除大鼠肝细胞能量代谢的影响  

Influence of hepatectomy plus portal vein arterialization on liver energy metabolism in rats

作　　者：李坚[1] 贾英斌[1] 关晓东[1] 蔡潮农[1] 周文英[2] 张百萌[1] 

机构地区：[1]中山大学附属第五医院普外三科,珠海519000 [2]中山大学附属第五医院中心实验室,珠海519000

出　　处：《消化肿瘤杂志（电子版）》2011年第1期40-44,共5页Journal of Digestive Oncology(Electronic Version)

基　　金：珠海市科技局医药卫生重大项目(编号PB20081002)

摘　　要：目的在大鼠肝部分切除基础上建立入肝门静脉动脉化加门腔分流术的动物模型,研究大鼠术后早期肝脏细胞能量代谢的变化。方法 90只Sprague-Dawley大鼠分为3组:肝切除组+门静脉动脉化组、单纯肝切除组及单纯门静脉动脉化组,每组30只。观察术前及术后5min吲哚靛青绿15min储留率(indocyanine green retention rate at15min,ICGR15)、术后5min及2h动脉血酮体比率(arterial blood ketone body ratio,AKBR)及肝组织能荷(energy charge,EC)的变化情况。结果肝部分切除或单纯门静脉动脉化手术均导致术后大鼠ICGR15明显升高(P<0.01),单纯门静脉动脉化大鼠肝脏吲哚靛青绿15min储留率显著低于肝部分切除大鼠(P<0.01),肝切除附加门静脉动脉化后,大鼠术后ICGR15明显低于单纯肝部分切除组(P<0.01)。肝部分切除或单纯行门静脉动脉化手术均导致术后大鼠AKBR及EC明显降低(P<0.01),单纯门静脉动脉化组大鼠术后2h开始出现回升,而肝部分切除大鼠仍持续下降。肝部分切除附加门静脉动脉化组AKBR及EC术后均明显高于单纯肝部分切除组(P<0.01)。结论肝部分切除或门静脉阻断的手术操作均明显降低肝脏细胞能量代谢水平,入肝门静脉动脉化能有效促进肝部分切除术后大鼠残肝细胞能量代谢水平的恢复。Objective To establish a rat model of portal vein arterialization after hepatectomy,and investigate the influence of hepatectomy plus portal vein arterialization on energy metabolism in rats.Methods Ninety Sprague-Dawley rats were assigned to three groups with 30 rats in each group,hepatectomy plus portal vein arterialization(HPVA),hepatectomy (PH) alone and portal vein arterialization(PVA) alone.Pre-and post-operative indocyanine green retention rate at 15 min (ICGR15),arterial blood ketone body ratio (AKBR) and energy charge (EC) were measured and compared among the three groups.Results After hepatectomy or PVA,ICGR15 increased,while AKBR and EC decreased significantly.ICGR15 5 minutes after operation was significantly lower in PVA group than those in the two hepatectomy groups,as well as in the group of hepatectomy plus PVA than that in hepatectomy alone group (P<0.01).AKBR and EC in PVA group rose again 2 h after operation,while still decreased in the two hepatectomy groups.Postoperative AKBR and EC were significantly higher in the group of hepatectomy plus PVA than that in hepatectomy alone group(P<0.01).Conclusions Energy metabolism of the liver remnant was dramatically damaged because of hepatectomy.Portal vein arterialization was an effective technique which can improve and promote energy metabolism of the liver remnant after hepatectomy.

关 键 词：门静脉动脉化 大鼠 吲哚靛青绿 储留率 动脉血酮比率 能荷 

分 类 号：R657.3[医药卫生—外科学]