肝硬化大鼠ALPPS术后肝功能及肝再生的变化  

Change of liver function and regeneration after portal vein ligation dombined within situ splitting on in cirrhosis rats

作　　者：秦玉刚[1] 张强[1] 赵哲 易文 白天一 魏小军[1] 欧阳才国[1] QIN Yugang;ZHANG Qiang;ZHAO Zhe;YI Wen;BAI Tianyi;WEI Xiaojun;OUYANG Caiguo(Department of Hepatobiliary Surgery,Aerospace Center Hospital,Beijing 100049,P.R.China;Department of General Surgery,Ninqiang Tianjin Hospital;Department of General Surgery,Chengde Sixth Hospital,Chengde Branch of Aerospace Center Hospital)

机构地区：[1]航天中心医院肝胆外科,北京100049 [2]宁强县天津医院普通外科 [3]承德市第六医院(航天中心医院承德分院)综合外科

出　　处：《滨州医学院学报》2020年第2期92-96,共5页Journal of Binzhou Medical University

基　　金：中国航天科工集团公司医疗卫生科研项目(2016-LCYL-004)。

摘　　要：目的通过比较正常大鼠和肝硬化大鼠模拟ALPPS术后AST、ALT、吲哚菁绿排泄试验、残余肝(肝中叶)再生率的变化,研究正常和肝硬化大鼠术后肝功能变化及与肝增生的相关性。方法选取正常和肝硬化(通过CCl4综合法诱导成模)SD雄性大鼠各25只,两组均随机分为5个亚组,即术后1、3、7、10、14 d组,每组5只大鼠,每个观测点分别抽血检测AST、ALT、ICG R15滞留率,取残余肝(肝中叶)称重,计算肝再生率。结果两组大鼠AST、ALT术后均明显增高,且实验组明显高于对照组,P<0.05,随后指标逐渐下降,对照组术后7 d恢复正常,实验组则需要14 d才基本恢复。ICG R15滞留率变化与其相似。术后残留的肝中叶体积和重量逐渐增生,但对照组明显快于实验组,Person相关分析显示术后肝功能和肝增生呈正相关性。结论肝硬化大鼠ALPPS术后肝功能损害实验组较对照组明显,恢复较对照组慢,肝功恢复与肝增生成正相关性。因此,术后肝脏体积可以作为评估肝功能的指标。Objective To test serum levels of ALT,AST,ICG R15 and calculating the hepatic regeneration rate(HRR)of remnants(median lobe)on normal and cirrhosis rats,to explore the rule of the liver function and regeneration after operation and analyse the correlation.Methods Thirty male SD rats with normal and cirrhosis(induced by CCl4)were randomly selected.The two group rats were divided into 5 subgroups,including the 1st,3rd,seveth,tenth,and fourteenth day subgroups.All of the rats were underwent ALPPS and were tested AST、ALT and ICG R15,and regeneration rate of residual liver was count.Results AST,ALT of two groups were raised after surgery,the experimental group was obviously higher than the control group,which had statistical difference.Next to the two levels were decreased gradually,the control group was normal in 7 days after surgery,while the experimental group was normal in 14 days after surgery.ICG R15 had the same change.Regeneration rate of residual liver increase gradually,but regeneration rate of the control group was faster than the experimental group.The correlation analysis showed thatthey had obvious correlation(r=0.841).The single factor linear regression analysis obtained an equation of regression:the control group was Y=-0.1647x+39.396(X was ICG R15,Y was regeneration rate of residual live).Conclusion The liver function injury of the experimental group was more obvious than the control group,and the recovery of liver function was slower than the control group,too.And the liver function had correlation with liver regeneration.So the volumes of residual live could be used as an index for evaluating liver function.

关 键 词：肝离断 门静脉结扎 肝再生 肝功能 肝硬化 

分 类 号：R363[医药卫生—病理学]