CAJ | 학술논문

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.
목적 연구간전성문정맥고압대서문정맥혈류개변대간장공능적영향.방법 웅성Wistar대서66지,완전수궤화분위5조:문정맥부분봉찰조(A조,n=20)；부분문정맥、간동맥순서봉찰조(B조,n=20)；간동맥봉찰조(C조,n=10)；가수술조(D조,n=10)；부분문정맥、간동맥동시봉찰조(E조,n=6).관찰술후12주각조병사솔화간공능변화정황.면역조화방법검측간장회관구소담관주위미혈관밀도、간장담관증생세포핵항원；투사전경관찰간장초미결구적개변.결과 술후12주간공능검측현시,A、B、C、D조곡초전안매분별시(132.69±21.03)U/L、(154.40±28.73)U/L、(125.84±26.60)U/L、(134.02±18.42)U/L,각조지간차이무통계학의의(P＞0.05)；곡병전안매각조분별시(39.33±8.62)U/L、(44.84±9.47)U/L、(40.41±8.04)U/L、(38.47±7.29)U/L,각조지간차이무통계학의의(P＞0.05).여C、D조상비,A조화B조병사솔분별위20％화25％,병사솔증가,간장소담관주위혈관밀도증가(P＜0.05)；B조간장담관증생세포핵항원표체증강,평균흡광도치위0.345±0.027,교A、C、D조(평균흡광도치분별위0.264±0.015、0.258±0.022화0.249±0.021)차이균유통계학의의(P＜0.01)；초미결구관찰A조화B조,세포질내가견교다지방과립취집,선립체가출현공포양변.결론 간전성문정맥고압대서문정맥측지혈류대간장생리공능적유지구유교위중요적작용；간전성문정맥고압가사간내담관상피세포화담관주위미혈관출현경도증생,간세포내발생지방과립취집；여과간동맥혈공상실,칙저사변화회경가현저.
Objective To observe the effect of portal blood flow on rat's liver with prehepatic portal hypertension.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 wereobserved at the 12th week after operation.Then the density of the microvascular in portal area and proliferating cell nuclear antigen expression of intro-hepatic bile duct epithelium were determined by immunohistochemical 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 anong all groups (P ＞0.05) at the 12th week after operation.Glutamie-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 t9.47)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 microvascular number in portal area increased obviously in group B and A(P ＜0.05).The proliferating cell nuclear antigen expressions 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 mitochondria 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 prehepatio portal hypertensive rat; the epithelium of intra-hepatic bile duct was mildly damaged and the microvascular number in hepatic portal area increased as well as the fat accumulated in hepatocytes of prehepatic portal hypertensive rat; if the hepatic artery blood supply is lost,these changes would become more obviously.