门静脉限流联合肝动脉结扎对大鼠肝再生与肝损伤的影响  

Effect of portal vein restriction combined with hepatic artery ligation on liver regeneration and injury in rats

作　　者：姚立彬 张文卓 朱孝成 Yao Libin;Zhang Wenzhuo;Zhu Xiaocheng(Department of General Surgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院普外科,徐州221006

出　　处：《中华肝胆外科杂志》2020年第9期703-706,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：徐州市科技计划项目重点研发计划(KC17201)。

摘　　要：目的分析门静脉限流联合肝动脉结扎对Sprague Dawley(SD)大鼠肝再生与肝损伤的影响。方法健康清洁级SD雄性大鼠24只,250~280 g,7~8周龄,采用随机数字表随机分为门静脉结扎(PVL)组、轻度限流组和中度限流组,每组各8只。PVL组结扎大鼠门静脉右叶支、尾叶支及左侧支,仅保留门静脉右侧支。轻度限流组和中度限流组操作同PVL,但门静脉左侧支轻度、中度限流,同时结扎肝动脉左侧支。术后72 h留取肝左中叶行HE染色并计算总坏死分数、肝右中叶行Ki-67免疫组化染色并计数阳性细胞数,计算肝右中叶肝再生率,检测血清肝功能指标。结果肝右中叶肝再生率PVL组为(109.1±10.9)%,中度限流组(105.0±12.3)%,均明显高于轻度限流组(67.1±6.4)%,差异均有统计学意义(均P<0.05)。肝右中叶Ki-67免疫组化染色结果与肝再生率结果一致。肝左中叶总坏死分数中度限流组4.50(3.25,6.00)分、PVL组2.00(1.25,3.00)分、轻度限流组0(0,0.75)分,三组总坏死分数呈降低趋势,差异均有统计学意义(均P<0.05)。轻度限流组丙氨酸氨基转移酶为(48.4±11.4)U/L,明显低于PVL组(67.2±12.2)U/L和中度限流组(74.3±14.2)U/L,差异均有统计学意义(均P<0.05)。三组天冬氨酸氨基转移酶、白蛋白以及总胆红素比较差异均无统计学意义(均P>0.05)。结论适当的门静脉限流联合肝动脉结扎能够有效诱导SD大鼠预留侧肝组织再生,同时控制阻塞侧肝组织损伤。ObjectiveTo evaluate the effect of portal vein restriction combined with hepatic artery ligation on Sprague Dawley(SD)rats liver regeneration and injury.MethodsTwenty-four healthy and clean SD male rats,250-280 g,7-8 weeks old,were randomly divided into portal vein ligation(PVL)group,mild restriction group and moderate restriction group with 8 rats in each group.In PVL group,the right,caudal and left branches of portal vein were ligated,and only the right branches of portal vein were preserved.The operation of mild and moderate restriction group was the same as PVL,however,the left branch of the portal vein was slightly and moderately restricted,and the left branch of the hepatic artery was ligated at the same time.At 72 hours after the operation,the left middle lobe was stained with hematoxylin-eosin and the total necrosis score was calculated.The right middle lobe was immunostained for Ki-67 and the number of positive cells was counted.The liver regeneration rate of the right middle lobe was calculated and the serum liver function indexes were measured.ResultsThe hepatic regeneration rate of right middle lobe in PVL group was(109.1±10.9)%,while that in moderate restriction group was(105.0±12.3)%,which was significantly higher than that in the mild restriction group(67.1±6.4)%,the differences were statistically significant(P<0.05).The Ki-67 result was also higher in the PVL group than the mild restriction group.The total necrosis score was 4.50(3.25,6.00)in moderate restriction group,2.00(1.25,3.00)in PVL group and 0(0,0.75)in mild restriction group.The three groups showed a decreasing trend and the differences were statistically significant(P<0.05).Alanine aminotransferase in mild restriction group was(48.4±11.4)U/L,was significantly lower than that in PVL group(67.2±12.2)U/L and moderate restriction group(74.3±14.2)U/L,the difference was statistically significant(P<0.05).There were no significant differences in serum levels of aspartate aminotransferase,albumin and total bilirubin among the three groups(

关 键 词：门静脉 肝动脉结扎 肝再生 肝损伤 

分 类 号：R657.3[医药卫生—外科学] R-332[医药卫生—临床医学]