摘要
目的研究肝前性门静脉高压大鼠门静脉血流改变对肝脏功能的影响。方法雄性Wistar大鼠66只，完全随机化分为5组：门静脉部分缝扎组（A组，n=20）；部分门静脉、肝动脉顺序缝扎组（B组，n=20）；肝动脉缝扎组（C组，n=10）；假手术组（D组，n=10）；部分门静脉、肝动脉同时缝扎组（E组，n=6）。观察术后12周各组病死率和肝功能变化情况。免疫组化方法检测肝脏汇管区小胆管周围微血管密度、肝脏胆管增生细胞核抗原；透射电镜观察肝脏超微结构的改变。结果术后12周肝功能检测显示，A、B、C、D组谷草转氨酶分别是（132．69±21．03）U／L、（154．40±28．73）U／L、（125．84±26．60）U／L、（134．02±18．42）U／L，各组之间差异无统计学意义（P〉0．05）；谷丙转氨酶各组分别是（39．33±8．62）U／L、（44．84±9．47）U／L、（40．41±8．04）U／L、（38．47±7．29、）U／L，各组之间差异无统计学意义（P〉0．05）。与c、D组相比，A组和B组病死率分别为20％和25％，病死率增加，肝脏小胆管周围血管密度增加（P〈0．05）；B组肝脏胆管增生细胞核抗原表达增强，平均吸光度值为0．345±0．027，较A、C、D组（平均吸光度值分别为0．264±0．015、0．258±0．022和0．249±0．021）差异均有统计学意义（P〈0．01）；超微结构观察A组和B组，细胞质内可见较多脂肪颗粒聚集，线粒体可出现空泡样变。结论肝前性门静脉高压大鼠门静脉侧支血流对肝脏生理功能的维持具有较为重要的作用；肝前性门静脉高压可使肝内胆管上皮细胞和胆管周围微血管出现轻度增生，肝细胞内发生脂肪颗粒聚集；如果肝动脉血供丧失，则这些变化会更加显著。
Objective To observe the effect of portal blood flow on rat＇ s liver with prehepatic portal hy- pertension. Methods Sixty-six male Wistar rats were randomly divided into five groups： partial portal vein transfixation group（ A, n = 20）, hepatic artery transfixation after partial portal veins transfixation group（ B, n = 20）, hepatic artery transfixation group （ C, n = 10 ）, SO group （ D, n = 10 ）, hepatic artery and partial portal vein transfixation group （ E, n = 6 ）. The mortality as well as the biochemical examination were observed at the 12th week after operation. Then the density of the microvascular in portal area and prolifera- ting cell nuclear antigen expression of intro-hepatic bile duct epithelium were determined by immunohisto- chemical staining method. The ultra microstructure changes of hepatocytes were observed under transmission electron microscope. Results Biochemical examination, including glutamic-oxa-lacetic transaminase, glutamic-pyruvic transaminase and total protein, showed no significant differences among all groups （P〉 0.05 ） at the 12th week after operation. Glutamic-oxalacetic transaminase in group A, in group B, in group C and in group D are （132.69 ±21. 03） U/L, （154.40 ±28.73） U/L, （125. 84 ±26.60） U/L, （134.02 ±18.42） U/L; glutamic-pyruvic transaminase in group A, in group B,in group C and in group Dare （39.33±8.62） U/L, （44.84±9.47） U/L, （40.41 ±8.04） U/L, （38.47 ±7.29） U/L. Compared with groups C and D, the mortality rate （group A 20% ; group B 25% ） , and the mierovaseular number in portal area increased obviously in group B and A（ P 〈 0.05 ）. The proliferating cell nuclear antigen expres- sions of intra-hepatic bile duct epithelium increased significantly in group B （ mean optical density 0. 345 ± 0. 027 compared with the rest groups mean optical density in group A, in group C and in group D are 0. 264 ± 0. 015, 0.258 ± 0.022, 0.249 ± 0. 021 ） （ P 〈 0.01 ） ; fat accumulation in the hepatocytes and mito- chondria vacuolization were observed under transmission electron microscopic in group A and group B. Conclusions The portohepatic collateral circulation still has its significance in liver blood supply of prehe- patic portal hypertensive rat ; the epithelium of intra- hepatic bile duct was mildly damaged and the microvas- cular number in hepatic portal area increased as well as the fat accumulated in hepatocytes of prehepatic por- tal hypertensive rat; if the hepatic artery blood supply is lost, these changes would become more obviously.
出处
《国际外科学杂志》
2012年第7期453-457,F0003,共6页
International Journal of Surgery
基金
国家“十五”攻关课题（No.2001BA705810-15）
