脾次全切除术对肝纤维化影响的实验研究  

Effects of subtotal splenectomy on liver fibrosis in rats

作　　者：曾仲[1] 马宏敏 

机构地区：[1]第三军医大学附属西南医院肝胆外科,重庆400038 [2]西南医院普外科

出　　处：《中华肝胆外科杂志》2001年第6期359-362,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　研究脾次全切除术对肝纤维化的影响。方法　用 6 0 %CCL4加 5 %乙醇制作大鼠肝纤维化模型 ,然后行全脾或脾次全切除 ,观察不同术式下大鼠血清肝纤维化指标的变化 ,用原位杂交和免疫组化的方法了解不同术式对肝中TGF β1、MT1 MMP、MMP2、TIMP1表达的影响。结果　肝纤维化大鼠脾手术前后外周血PCIII、HA、LN和PLD均显著高于正常对照组 (P <0 0 1) ,不同术式组间比较差异无显著性意义 (P >0 0 5 )。TGF β1、MT1 MMP、MMP2、TIMP1主要表达在激活的肝贮脂细胞(肌成纤维细胞 )中 ,图像分析显示TGF β1的表达术后明显低于术前 (P <0 0 1) ,但均较正常对照组显著升高 (P <0 0 1) ,而术后各组间比较差异无显著意义 (P >0 0 5 )。纤维化肝中MT1 MMP、MMP2、和TIMP1的表达均高于正常组 (P <0 0 1) ,但术前术后及术后各组间比较差异均无统计学意义 (P >0 0 5 )。结论　脾次全切除后保留的残脾没有加重肝纤维化。Objective To investigate the effects of subtotal splenectomy on liver fibrosis. Methods After liver fibrosis was induced with 60% carbon tetrachloride and 5% alcohol in rats, the rats were randomized into 4 groups of operative liver fibrosis (OLF), total splenectomy (TS), subtotal splenectomy (SS) and sham operation (SO). The values of serum PCIII, HA, LN and PLD were determined. Meanwhile, the level and cellular sites of gene expression of TGF-β1, MT1-MMP, MMP2 and TIMP1 were detected with immunohistochemistry and in situ hybridization. Results No significant differences in levels of PCIII, HA, LN and PLD were found between the TS group and SS group (P>0.05). However, the levels were markedly higher in rats with liver fibrosis than in the controls (P<0.0001). The expression of TGF-β1, MT1-MMP, MMP2 and TIMP2 occurred predominantly in activated myofibroblasts, fat-storing cells. Image analysis showed that the level of TGF-β1 in fibrotic cells was lower after than before the operation (P<0.0001). However, it was still significantly higher than that in the controls (P<0.0001). After operation, the level was not remarkably different among the 4 experimental groups (P>0.05). The level of expression of MT1-MMP, MMP2 and TIMP1 was significantly higher in the experimental groups than in the control (P<0.0001). But there were no marked differences in their expression in 1 group before and after the operation and among the 4 groups after the operation (P>0.05). Conclusion The residual splenic tissue after subtotal splenectomy does not aggravate the liver fibrosis.

关 键 词：肝硬化 脾次全切除术 巨脾症 

分 类 号：R657.31[医药卫生—外科学] R657.6[医药卫生—临床医学]