肝硬化大鼠门静脉动脉化对肝脏血流动力学的影响  

Impacts of portal vein arterialization on hepatic hemodynamics in rats with liver cirrhosis

作　　者：蔡潮农[1] 苏永辉[1] 李培平[1] 李坚[1] 张百萌[1] 郭辉[2] 

机构地区：[1]中山大学附属第五医院普通外科,珠海519000 [2]中山大学附属第五医院超声科,珠海519000

出　　处：《中华肝脏外科手术学电子杂志》2014年第5期52-55,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：珠海市科技局医药卫生重大项目(PB20081002)

摘　　要：目的探讨肝硬化大鼠门静脉动脉化(PVA)对肝脏血流动力学的影响。方法取50只肝硬化模型大鼠按随机数字表法随机分为PVA组(40只)和对照组(10只)。PVA组行PVA+门-腔静脉分流术,对照组未行任何处理。检测每组大鼠术后或入组后1周(T1)、2周(T2)、4周(T3)、8周(T4)4个时间点的门静脉内径、最大血流速度、流量及门静脉压力的变化。组内各时间点比较采用单因素方差分析,两两比较采用LSD-t检验,组间比较采用t检验。结果 PVA组术后门静脉均呈动脉血流信号,T1、T2、T3、T4时间点门静脉内径为(2.23±0.19)、(2.34±0.26)、(2.43±0.27)、(2.47±0.22)mm,对照组为(1.91±0.19)mm,PVA组T1、T2、T3、T4时间点的门静脉内径均较对照组明显增大(t=3.77,4.22,5.01,6.05;P<0.05),T4时间点的门静脉内径较T1时明显增大(LSD-t=2.61,P<0.05)。PVA组T1、T2、T3、T4时间点门静脉最大血流速度为(39.5±2.0)、(40.4±2.5)、(39.4±2.7)、(38.8±2.6)cm/s,对照组为(11.3±2.1)cm/s,PVA组T1、T2、T3、T4时间点的门静脉最大血流速度均较对照组明显增大(t=30.57,28.13,26.05,26.25;P<0.05)。PVA组T1、T2、T3、T4时间点门静脉流量为(53±10)、(60±14)、(67±15)、(64±10)ml/min,对照组为(11±4)ml/min,PVA组T1、T2、T3、T4时间点的门静脉流量均较对照组明显增大(t=12.71,10.66,11.44,16.00;P<0.05),T3时间点的门静脉流量较T1时明显增大(LSD-t=2.39,P<0.05)。PVA组T1、T2、T3、T4时间点门静脉压力为(18.3±1.6)、(18.5±1.4)、(18.3±1.5)、(18.2±1.4)cm H2O(1 cm H2O=0.098 k Pa),对照组为(16.3±1.7)cm H2O,PVA组T1、T2、T3、T4时间点的门静脉压力均较对照组明显升高(t=2.80,3.14,2.93,2.83;P<0.05)。结论 PVA能够有效增加入肝血供,且不会使门静脉内径、血流速度、流量、压力持续增加,可维持在稳定的高位水平。Objective To investigate the impacts of portal vein arterialization （PVA） on the hepatic hemodynamics in rats with liver cirrhosis. Methods Fifty rats with liver cirrhosis model were randomly divided into PVA group （n=40） and control group （n=10） according to the random number table method. Rats in the PVA group underwent PVA ＋ portacaval shunt. Rats in the control group received no treatment. The variation of portal vein inner diameter, max velocity （Vmax）, blood flow and pressure of rats in each 〈br〉 group were measured at the time of 1 week （T1）, 2 weeks （T2）, 4 weeks （T3） and 8 weeks （T4） after operation or enrolling in the group. Parameters of every time points within the group were compared by one-way analysis of variance and pairwise comparison was conducted by LSD-t test. Comparison between groups was conducted by t test. Results Arterial blood flow signal was observed in the portal vein in PVA group after operation. The inner diameters of portal vein at T1, T2, T3, T4 in PVA group [（2.23±0.19）, （2.34±0.26）, （2.43±0.27）, （2.47±0.22） mm ] were significantly enlarged compared with that in control group [（1.91±0.19） mm （t=3.77, 4.22, 5.01, 6.05; P〈0.05）. The inner diameter of portal vein at T4 was significantly enlarged compared with T1 （LSD-t=2.61, P〈0.05）. The Vmax of portal vein at T1, T2, T3, T4 in PVA group [ （39.5±2.0）, （40.4±2.5）, （39.4±2.7） , （38.8±2.6） cm/s] were significantly increased compared with that in control group [（11.3±2.1） cm/s] （t=30.57, 28.13, 26.05, 26.25; P〈0.05）. The blood flow of portal vein at T1, T2, T3, T4 in PVA group [ （53±10）, （60±14）, （67±15）, （64±10）ml/min] were significantly increased compared with that in control group [（11±4） ml/min] （t=12.71, 10.66, 11.44, 16.00; P〈0.05）. The blood flow of portal vein at T3 was significantly increased compared with T1 （LSD-t=2.39, P〈0.05）. The portal vein pressure at T1, T2, T3, T4 in PVA group [�

关 键 词：肝硬化 实验性 门静脉动脉化 门腔分流术 外科 血流动力学 大鼠 

分 类 号：R657.3[医药卫生—外科学]