CAJ | 학술논문

目的：评价经改进的TECAI型生物人工肝脏支持系统（bioartificial liver supportsystem,BALSS）治疗醋氨酚诱发急性肝衰竭(acute liver failure,ALF)犬的有效性和安全性。方法：采用多次皮下注射醋氨酚的方法建立ALF模型犬。分离中国实验用小型猪肝细胞并培养于BALSS中，对ALF犬进行6小时的治疗，观察治疗前后犬生理、生化和组织学的变化，与常规药物治疗组和对照组进行比较。结果：注射醋氨酚48小时后，可建立ALF犬模型，模型成功率为63.16%。应用我们改进的酶消化法，平均从每只小型猪的肝脏可得到（0.8～3.0）×1010个肝细胞且存活率较高。TECAI型BALSS对ALF犬治疗后，血氨、丙氨酸转氨酶、天冬氨酸转氨酶和碱性磷酸酶等生化指标明显下降，支链氨基酸/芳香族氨基酸比值显著上升，其肝脏的病理改变得以修复，治疗后犬可长期存活（＞30日）。药物治疗组和对照组的ALF犬病情持续恶化，并于治疗后14.83～60.00小时内死亡。结论：此型BALSS能够迅速、安全、有效地暂时替代药物诱发的ALF犬的肝脏功能，其疗效明显优于常规药物治疗，BALSS可望成为救治ALF的新方法。
목적：평개경개진적TECAI형생물인공간장지지계통（bioartificial liver supportsystem,BALSS）치료작안분유발급성간쇠갈(acute liver failure,ALF)견적유효성화안전성。방법：채용다차피하주사작안분적방법건립ALF모형견。분리중국실험용소형저간세포병배양우BALSS중，대ALF견진행6소시적치료，관찰치료전후견생리、생화화조직학적변화，여상규약물치료조화대조조진행비교。결과：주사작안분48소시후，가건립ALF견모형，모형성공솔위63.16%。응용아문개진적매소화법，평균종매지소형저적간장가득도（0.8～3.0）×1010개간세포차존활솔교고。TECAI형BALSS대ALF견치료후，혈안、병안산전안매、천동안산전안매화감성린산매등생화지표명현하강，지련안기산/방향족안기산비치현저상승，기간장적병리개변득이수복，치료후견가장기존활（＞30일）。약물치료조화대조조적ALF견병정지속악화，병우치료후14.83～60.00소시내사망。결론：차형BALSS능구신속、안전、유효지잠시체대약물유발적ALF견적간장공능，기료효명현우우상규약물치료，BALSS가망성위구치ALF적신방법。
Objective:To assess the efficacy and safety of reformed typeTECAI bioartificial liver support system(BALSS) on treatment of acute liver failure(ALF)in a canine model induced by acetaminophen. Methods:The ALF canine model by multiple subcutaneous injections of acetaminophen were replicated. The primary hepatocytes were separated from the swine and cultured within the BALSS. The ALF model was treated with BALSS for six hours, the changes in physiological,biochemical and histological parameters were observed before and after the treatment ,and compared them with that after drugs treatment and control groups. Results:The ALF canine model was developed 48 hours after administrate of acetaminophen, the successful rate of model was 63.16%. Using our modified enzymatic digestion method, the yield of hepatocytes was (0.83.0)×1010 from per swine with high viability. Type TECAI BALSS treatment resulted in beneficial effects with decrease in plasma NH3, alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP) levels decreased,and the ratio of branchchain amino acid to aromatic amino acid(BCAA/AAA) increased. The pathological changes of the liver were repaired,and the animals with ALF could live longer than 30 days. The conditions of ALF models after the coventional treatment and control groups deteriorated,and they died within 14.8360.00 hours. Conclusions:This type of BALSS is rapid,safe and efficacious in providing liver support in the ALF canine model.The efficacy of BALSS is superior to the routine drugs treatment,and it would hopefully be a new method in the treatment of ALF.