入肝门静脉动脉化加门腔分流术对大鼠肝脏再生影响.docVIP

入肝门静脉动脉化加门腔分流术对大鼠肝脏再生影响 　 作者：李坚 关晓东 刘琦 谢玉妍 蔡潮农 张百萌 【摘要】 【目的】 在大鼠70%肝部分切除基础上建立入肝门静脉动脉化加门腔分流术的模型，并研究大鼠肝脏再生情况。【方法】 155只Sprague-Dawley大鼠分为3组。实验组大鼠65只，利用右肾动脉行入肝门静脉动脉化，并行门腔分流及肝部分切除，肝切组大鼠65只，仅进行肝部分切除，对照组大鼠25只，仅右肾切除。分别观察实验组及肝切组术后2、7、14及28 d残肝再生比率变化，以及3组在术中0 h、术后24、48、72 h及7 d各时相点残肝肝脏S期细胞比例及增殖细胞核抗原(PCNA)阳性表达的肝细胞比例情况。【结果】 术后2、7、14 d两组肝脏再生比率相比，实验组较肝切组明显增高，差异有显著统计学意义(P lt; 0.01);至术后28 d，实验组及肝切组肝脏再生比率趋平，差异无统计学意义(P gt; 0.05)。术后各时相点实验组及肝切组残肝S期肝细胞比例及PCNA阳性表达肝细胞比例均较对照组明显升高，差异有显著统计学意义(P lt; 0.01)。实验组与肝切组相比，术后24 h残肝S期细胞比例及PCNA阳性细胞比例均已经开始升高，至术后48、72 h及术后7 d，实验组仍明显高于肝切组，差异有显著统计学意义(P lt; 0.01)。【结论】 入肝门静脉动脉化重建入肝血流对大鼠肝细胞的增生及增殖有促进作用，是预防肝部分切除术后急性肝功能衰竭的有效方法。 【关键词】 门静脉动脉化; 肝切除术; 再生; 增殖细胞核抗原 　Abstract： 【Objective】 Extended hepatectomy may result in acute postoperative liver failure， the aim of this study was to assess the effects of portal vein arterialization (PVA) associated with portocaval shunt (PCS) on liver regeneration after 70% partial hepatectomy (PH) in a rat model. 【Methods】 One hundred and fifty-five Sprague Dawley rats were assigned to three groups： PVA associated with PCS after 70% PH (experimental group); 70% PH only (PH group); right nephrectomy (control group). Liver regeneration rate (LRR) was assessed on days 2， 7， 14， and 28 after surgery， proliferating cell nuclear antigen (PCNA) labeling index， and S phase liver cell rate were assessed on 0 h， 24 h， 48 h， 72 h， and 7 days after surgery， respectively. 【Results】 Rats with 70% PH following PVA + PCS showed significantly greater liver growth than rats with 70% PH only in the first 14 days postoperatively (P lt; 0.01). However， no significant difference was found 28 days after surgery between these two groups. The rats with PVA + PCS showed the highest values of PCNA labeling index and S phase liver cell rates within 7 days， and higher than the other two non-PVA groups significantly (P lt; 0.01). 【Conclusions】 The present findings indicate that PVA technique bring beneficial effects on maintaining liver regeneration a