摘要
目的探讨肝部分切除大鼠内毒素血症与再生肝组织结构以及功能的动态变化规律及其意义。方法102只健康雄性成年Wistar大鼠随机分为正常对照（NC）组、假手术（SO）组和肝部分切除（PH）组，在不同时间点检测循环血内毒素（ET）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、白蛋白（ALB）、结合胆红素（CB）与透明质酸（HA）水平以及肝组织病理学改变。结果血清ET在PH术后6～72h期间升高，在12h、48h呈现峰值，分别与NC组比较（P〈0．05，P〈0．01）；血清ET在SO组各时间点与NC组比较差异无显著性。血清ALT在PH组术后6～72h期间升高，与血清ET动态变化趋势比较呈正相关（r=0．817，P〈0．01）；血清AST在PH组术后6～48h期间升高，与血清ET动态变化趋势比较呈正相关（r=0．717，P〈0．05）；血清ALB在PH组术后6～72h期间下降，与血清ET动态变化趋势比较呈负相关（r=-0．790，P〈0．05）；血清CB在PH组术后6～48h期间升高，与血清ET动态变化趋势比较呈正相关（r=0．836，P〈0．01）；血清HA在PH组术后6～72h期间升高，与血清ET动态变化趋势比较呈正相关（r=0．849，P〈0．01）；上述肝功能各指标在SO组各时间点与NC组比较差异均无显著性。再生肝组织出现损伤的时间段与血清ET升高的时间段（6～72h）一致，肝细胞坏死明显的时间点与血清ET出现峰值的时间点（12h，48h）一致；SO组各时间点肝组织与NC组肝组织比较无显著差异。结论PH后产生的内毒素血症可能直接造成再生肝组织结构与功能损伤，但这种损伤在数天内可自行完全恢复。提示对健康机体施行肝部分切除获取供肝是安全的。
Objective To compare and evaluate the dynamic changes between endotoxemia and regenerating liver formation and function after partial hepatectomy（ （PH） in rats. Methods One - hundred and two adult Male Wistar rats were randomly divided into three groups： A normal control （NC） group, a partial hepatectomized （PH） group and a sham operated （SO） group. To study the dynamic changes of endotoxemia and liver formation and function,rats were sacrificed before and at different time points after partial hepatectomy intervention（ 6 h,12 h, 24 h, 36 h, 48 h, 72 h,120 h and168 h）. Took NC group as Oh observation time point,namely Oh group. For each time point indicated,six rats were used in parallel. Levels of endotoxin （ET）, ALT, AST, ALB, CB and HA were determined in serum. The histopathologieal changes of regenerating liver were examined by microscopy. Results Serum ET levels significantly increased during 6 - 72 h period dynamic time points after PH, there were two peak values at 12 h ,48 h. and compared respectively with the ET leave of NC group（ P 〈 0.05. P 〈0.01 ）. Serum ALT levels were increased significantly during 6- 72 h after PH, there was positive relationship between the dynamic changes of ALT and ET（ r = 0. 817. P 〈 0.01 ）. Serum AST levels were increased significantly during 6 -48 h after PH, there was positive relationship between the dynamic changes of AST and ET （ r = 0.717, P 〈 0.05 ）. Serum ALB levels were decreased significantly during 6 - 72 h after PH, there was negative relationship between the dynamic changes of ALB and ET （ r = - 0. 790, P 〈 0.05 ）. Serum CB levels were increased significantly during 6h - 48h after PH, there was positive relationship between the dynamic changes of CB and ET（ r = 0. 836, P 〈 0.01 ）. Serum HA levels were increased significantly during 6 - 72 h after PH, there was positive relationship between the dynamic changes of HA and ET （ r = 0. 849, P 〈 0.01 ）. Regenerating liver appeared swelling and necrosis of liver cells during 6 -72 h period but mainly at 12 h,48 h after PH. There were no significantly difference in all the indexes above between SO groups and NC group. Conclusion Endotoxemia induced by PH could directly cause the injury of regenerting liver, but this kind injury could return to normal in a few days. This is suggested that it is safe to get donor liver from health adult by PH.
出处
《临床和实验医学杂志》
2007年第11期11-13,共3页
Journal of Clinical and Experimental Medicine
关键词
肝部分切除
内毒素血症
肝损伤
动态比较
Partial hepatectomy
Endotoxemia
Liver injury
Dynamic comparison
