肠屏障和肝屏障损伤及保护在减体积肝移植术后小肝综合征中的研究进展  

Injury of the hepatic barrier and intestinal barrier in patients with small-forsize graft syndrome after partial liver transplantation:mechanisms and protective measures

作　　者：严笑鹏[1] 仇毓东[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肝胆外科,江苏省南京市210008

出　　处：《世界华人消化杂志》2012年第1期47-52,共6页World Chinese Journal of Digestology

基　　金：国家传染病防治科技重大专项基金资助项目;No.2008ZX10002-26~~

摘　　要：肠屏障可以抵抗病原体的侵袭,阻止有害物质进入血液循环,从而保持机体内环境的稳定.肝屏障对于维护肝脏正常功能有重要意义,其可阻止内毒素、病毒等进入肝脏损伤肝细胞.肠屏障和肝屏障是减体积肝移植术后最易受到损伤的2个结构,其损伤的原因与术后"小肝综合征"的发生有关."小肝综合征"的发病机制与肝移植术后门静脉高压、门静脉过度灌注等有关.如何有效地控制"小肝综合征"的发生,保护术后的肠屏障和肝屏障,是维持肠道和肝脏功能的关键点.本文主要阐述肠屏障和肝屏障的概念,分析其功能和结构破坏的原因以及相应的保护措施.The intestinal barrier can resist the invasion of pathogens and prevent harmful substances from going into blood circulation to maintain the sta- bility of internal environment, while the hepatic barrier is a vital structure that can protect liver function and prevent endotoxin and virus from entering the liver to damage hepatocytes. Both the two barrier structures are most vulnerable to damage after partial liver transplantation due to the occurrence of postoperative ＇small-for-sizegraft syndrome＇. The pathogenesis of ＇small-for- size graft syndrome＇ is associated with postop- erative portal hypertension and hyperperfusion. How to effectively control the occurrence of ＇small-for-size graft syndrome＇ and to protect the intestinal barrier and hepatic barrier postop- eratively are key to the maintenance of intestinal and hepatic functions. The primary aim of this paper is to review the mechanisms underlying the development of injury of the hepatic barrier and intestinal barrier in patients with small-for- size graft syndrome after partial liver transplan- tation and to propose the corresponding protec- tive measures.

关 键 词：减体积肝移植 肝屏障 肠屏障 紧密连接 炎性因子 

分 类 号：R657.3[医药卫生—外科学]