术前不同引流方式减黄对梗阻性黄疸大鼠部分肝切除术后肝功能和肝再生的影响  

Effect of internal and external biliary drainage on liver regeneration of the obstructive jaundice rats following PH

作　　者：袁晟光[1] 梁科伟[1] 刘杰[1] 廖维甲[1] 覃理灵[1] 何松青[1] 

机构地区：[1]桂林医学院附属医院,广西桂林541001

出　　处：《山东医药》2012年第48期42-45,I0004,共5页Shandong Medical Journal

基　　金：广西卫生厅医疗卫生重点科研项目(重200983)

摘　　要：目的了解术前不同引流方式减黄对梗阻性黄疸(OJ)SD大鼠部分肝切除术(PH)术后肝功能和肝再生的影响。方法建立OJ不同引流方式减黄70%部分肝切除SD大鼠动物模型。并在术后0、1、2、4、12、24、48和72h收集大鼠血液及肝脏组织标本,测定血清TBIL、ALB、ALT、AST水平,计算残肝重量、肝再生率,免疫组化法观察肝脏组织PCNA表达,ELISA法检测血清TNF-α水平。结果 PH术后各时段内引流(ID)组和外引流(ED)组TBIL、ALT、AST水平较OJ组均偏低。各时段ID组ALB水平较OJ组、ED组偏高。72 h肝再生率ID组高于ED组,ED组高于OJ组。3组PCNA水平均于12 h明显升高,ID组于24 h达高峰,OJ组、ED组高峰延迟至48 h且峰值偏低。PH术后各组血清TNF-α水平均呈上升趋势,ID组于12 h达高峰,OJ组、ED组均于24 h达高峰,各时段OJ组、ED组血清TNF-α水平较ID组均偏高。结论内外引流术均可改善OJ所致的高胆红素血症和肝功能,并改善OJ大鼠残肝再生能力,但内引流效果更明显,且内引流术可以有效降低血清TNF-α水平。Objective To evaluate the effect of internal and external biliary drainage on liver regeneration of the obstructive jaundice（OJ） rats following partial hepatectomy（PH） and to provide a theoretical basis for clinical application.Methods We established the model of OJ SD rats drainaged internally and externally following PH.At 0 h,1 h,2 h,4 h,12 h,24 h,48 h and 72 h after PH,the rats were succumbed and the specimens of blood and liver were collected.The levels of TBIL,ALB,ALT,AST in serum and liver regeneration rates were determined.The expression of PCNA in residual liver tissues were analyzed by immunohistological technology.The levels of TNF-α in serum were measured by ELISA.Results After PH,the levels of TBIL,ALT and AST in OJ group were significantly higher than those in ID group and ED group at every moment.The level of ALB in ID group was significantly higher than in OJ group and ED group at every moment.The liver regeneration rate in ID group was significantly higher than those in OJ group and ED group at 72 h.The expression of PCNA in all of groups were obviously increased at 12 h,and peaked at 24 h in ID group.The expression of PCNA peaked at 48 h in OJ group and ED group,and the peak values were delayed and significantly lower than ID group.The levels of TNF-α in serum peaked at 12 h in ID group and at 24 h in OJ group and ED group.The levels of TNF-α in ID group were significantly lower than in OJ group and ED group at every moment.Conclusions Both internal and external drainage can improve liver regeneration of OJ rats following PH,but the liver regeneration after internal drainage is better improved.Internal biliary drainage can decreased the levels of TNF-α.

关 键 词：黄疸 梗阻性 肝再生 胆管引流 增殖细胞核抗原 

分 类 号：R657.4[医药卫生—外科学]