大鼠小体积肝移植中肝动脉重建的意义探讨  

Significance of arterial reconstruction on the model of small size orthotopic liver transplantation in rats

作　　者：徐贵云[1] 江艺[2] 陈海燕[3] 潘凡[2] 

机构地区：[1]淮安市第二人民医院普外科,江苏省223002 [2]南京军区福州总医院南京军区肝胆外科研究所 [3]淮安市第二人民医院检验科,江苏省223002

出　　处：《中华普外科手术学杂志（电子版）》2009年第1期56-58,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨肝动脉重建在大鼠小体积肝移植中的意义。方法采用改良二袖套法建立大鼠40%小体积肝移植模型,实验分动脉重建组(A组)和非动脉重建组(B组),观察1周生存率,并于术后第1、2、4、7天检测肝功能、移植肝组织学变化和免疫组化法检测肝细胞的增殖细胞核抗原(PCNA)。结果A组1周生存率66.7%,B组1周生存率50.0%(P>0.05)。ALT和TB术后第1天即开始明显增高,第2天达高峰,以后逐渐降低,B组和A组各时间点相比较,TB第2、7天高于A组,ALT第4、7天高于A脉组,差异有显著性意义(P<0.05)。A组术后中央静脉及肝窦扩张程度相对较轻,可见较多二倍体和多倍体肝细胞。PCNA表达于术后第2天最高,A组术后第1天的移植肝细胞PCNA阳性表达率高于B组,而术后第7天移植肝细胞PCNA阳性表达率低于B组,差异有显著性意义(P<0.05)。结论肝动脉重建可明显改善大鼠小体积移植肝的功能,促进移植肝的再生,有效地保护移植肝的组织学结构,减轻术后移植肝的组织学改变。Objective To investigate the significance of arterial reconstruction on the model of 40% small size orthotopic liver transplantation in rats. Methods Modified two-cuff technique was applied to establish a rat model of 40% orthotopic liver transplantation. A total of 96 sprague dawley （SD） rats were randomly divided into 2 groups： small size orthotopic liver transplantation with arterial reconstruction group （group A） and small size orthotopic liver transplantation without arterial reconstruction group （group B）. One week survival rate , main indexes of liver function, histology and the expression of the proliferative cell nuclear antigen （PCNA） of liver graft by immunohistochemical method were detected on the 1 st,2nd,4th and 7th day after transplantation, respectively. Results One week survival rate of group A and group B was 66.7% and 50.0% respectively （P 〉 0.05）. Alanine aminotransferase （ALT） and total bilirubin （TB） began to elevate from the first day and peaked on the second day after surgery. The leavels of ALT in group B on the fourth and seventh day were higher significantly than those in group A （P 〈 0.05）. The levels of TB in group B on the second and seventh day were higher significantly than those in group A （ P 〈 0. 05 ）. Histological findings indicated that more diploid and polyploid hepatocytes could be seen in group A. The expression of PCNA of liver graft peaked on the 2nd day after surgery. The expression of PCNA of group A was higher on the first day and lower on the 7th day than that of group B after operation （ P 〈 0.05 ）. Conclusions Arterial reconstruction can improve the function of liver grafts after small size orthotopic liver transplantation, alleviate the histological changes and promote the regeneration of liver grafts quickly.

关 键 词：肝移植 大鼠 sprague—dawley 疾病模型 动物 肝动脉 

分 类 号：R657.3[医药卫生—外科学]