CAJ | 학술논문

目的探索在梗阻性黄疸时,不同范围肝切除联合肝动脉切除对肝细胞再生和凋亡的影响.方法 155只雄性SD大鼠行胆总管结扎制备梗阻性黄疽模型,5 d后二次手术分为:胆肠再通内引流组;肝切除(42%、70%)联合胆肠再通内引流组;肝切除(42%,70%)联合肝固有动脉切除、胆肠再通内引流组.动态观察二次手术后24 h、72 h、7 d肝组织HGF、bcl-2 mRNA含量及蛋白表达、肝细胞增殖和凋亡指数的变化,并统计各组死亡率.结果高胆红素血症、行胆肠冉通内引流的同时,大鼠肝切除或肝切除联合肝动脉切除后,肝再生均受抑制,凋亡增多;较之肝切除组和42%肝切除联合肝固有动脉切除组.70%肝切除联合肝固有动脉切除组术后肝组织HGF、bcl-2 mRNA含量显著减少,肝细胞再生明显受抑而凋亡显著增多,死亡率显著增高(P<0.05).结论高胆红素血症时,肝切除量是影响大鼠肝切除联合肝动脉切除实施安全性的重要因素,42%肝切除联合肝固有动脉切除、胆肠再通内引流,对肝细胞再生和凋亡影响较小,安全町行;70%肝切除联合肝动脉切除、胆肠再通内引流后肝细胞再生显著受抑制,凋亡增多,死亡率高,应避免实施.
목적 탐색재경조성황달시,불동범위간절제연합간동맥절제대간세포재생화조망적영향.방법 155지웅성SD대서행담총관결찰제비경조성황저모형,5 d후이차수술분위:담장재통내인류조;간절제(42%、70%)연합담장재통내인류조;간절제(42%,70%)연합간고유동맥절제、담장재통내인류조.동태관찰이차수술후24 h、72 h、7 d간조직HGF、bcl-2 mRNA함량급단백표체、간세포증식화조망지수적변화,병통계각조사망솔.결과 고담홍소혈증、행담장염통내인류적동시,대서간절제혹간절제연합간동맥절제후,간재생균수억제,조망증다;교지간절제조화42%간절제연합간고유동맥절제조.70%간절제연합간고유동맥절제조술후간조직HGF、bcl-2 mRNA함량현저감소,간세포재생명현수억이조망현저증다,사망솔현저증고(P<0.05).결론 고담홍소혈증시,간절제량시영향대서간절제연합간동맥절제실시안전성적중요인소,42%간절제연합간고유동맥절제、담장재통내인류,대간세포재생화조망영향교소,안전정행;70%간절제연합간동맥절제、담장재통내인류후간세포재생현저수억제,조망증다,사망솔고,응피면실시.
Objective To study liver regeneration and hepatocyte apoptosis in the obstructive jaundice liver after partial hepatectomy (PH) at different volumes with hepatic artery resection (HAR).Methods One hundred fifty five male SD rats which underwent common bile duct ligation (CBDL) for 5 days were randomized into following groups:the bile duct obstruction and reperfusion of bile flow (BDO-RBF) group,42% PH with BDO-RBF group,70% PH with BDO-RBF group,42% PH with HAR and BDO-RBF group and 70% PH with HAR and BDO-RBF group.The levels of HGF,bcl-2 mRNA and protein,hepatocyte proliferation/apoptosis index in hepatic tissues were dynamically observed after operation (24 h,72 h and 7 d).Mortality was calculated.Results Compared with other groups,hepatocyte proliferation /apoptosis index and the HGF,bcl-2 mRNA content of liver tissue in 70% PH with HAR group were aggravated and had a significantly increased mortality on in rats after obstructive jaundice (P<0.05).Conclusion (1)Both the liver regeneration and apoptosis are influenced by conspicuous bilirubinemia,hepatectomy and hepatic artery resection in rats after obstructive jaundice,especially by the liver resection volume and conspicuous bilirubinemia.(2) Under the condition of conspicuous bilirubinemia,the influence of 70% PH with HAR on liver regeneration and apoptosis is severer than its counterpart of 42% in the rats.Thus,the former is not safe and should be avoided and the later can be used.