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中华普通外科学文献(电子版) ›› 2014, Vol. 08 ›› Issue (05) : 359 -364. doi: 10.3877/cma.j.issn.1674-0793.2014.05.006

所属专题: 文献

论著

入肝门静脉动脉化对大鼠肝脏损害的初步研究
蔡潮农1, 苏永辉1, 郭辉2, 李培平1, 李坚1, 张百萌1, 杨禄坤3,()   
  1. 1. 519000 珠海,中山大学附属第五医院普外3区
    2. 519000 珠海,中山大学附属第五医院超声科
    3. 519000 珠海,中山大学附属第五医院麻醉科
  • 收稿日期:2014-03-14 出版日期:2014-10-01
  • 通信作者: 杨禄坤
  • 基金资助:
    珠海市科技局医药卫生重大基金资助项目(PB20081002)

Preliminary study on liver damage following portal vein arterialization associated with portocaval shunt in rats

Chaonong Cai1, Yonghui Su1, Hui Guo2, Peiping Li1, Jian Li1, Baimeng Zhang1, Lukun Yang3,()   

  1. 1. The Third Department of General Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
  • Received:2014-03-14 Published:2014-10-01
  • Corresponding author: Lukun Yang
  • About author:
    Corresponding author: Yang Lukun, *Department of Anesthesiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China, Email:
引用本文:

蔡潮农, 苏永辉, 郭辉, 李培平, 李坚, 张百萌, 杨禄坤. 入肝门静脉动脉化对大鼠肝脏损害的初步研究[J/OL]. 中华普通外科学文献(电子版), 2014, 08(05): 359-364.

Chaonong Cai, Yonghui Su, Hui Guo, Peiping Li, Jian Li, Baimeng Zhang, Lukun Yang. Preliminary study on liver damage following portal vein arterialization associated with portocaval shunt in rats[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(05): 359-364.

目的

初步研究入肝门静脉完全动脉化加门腔分流术对大鼠肝脏的损害程度。

方法

100只肝硬化造模大鼠随机分为A组(n=40),入肝门静脉完全动脉化(PVA)+门腔分流(PCS);B组(n=40),仅行门腔完全分流;C组(n=20),门静脉阻断30 min+右肾切除。分别将各组大鼠术前和术后1、2、4、8周的肝组织切片行肝细胞诱导型一氧化氮合成酶(iNOS)免疫组织化学染色,然后进行图像分析。各取8只正常大鼠,分别于PVA术前及术后4、8周行肝组织切片,马松染色后分析正常大鼠PVA手术前后肝脏纤维增生情况。

结果

(1)A组2只(5%)大鼠肝脏切片中常规HE染色可见汇管区明显扩张,小叶间静脉内径显著扩张,静脉壁增厚明显,壁内可见红染的纤维增生。(2)大鼠刚完成肝硬化造模时,肝细胞胞质的iNOS表达至峰值,3组平均IOD达600583±32 828;3组大鼠术后均较术前有明显下降,差异有统计学意义(P<0.01);术后4周内,A组仍明显高于B、C两组,差异有统计学意义(P<0.01);至术后8周时,3组iNOS表达差异无统计学意义。(3)正常大鼠肝间质胶原纤维染色在术前及术后4、8周的总累积光密度值差异无统计学意义。

结论

术后8周内,PVA不会导致正常大鼠肝间质纤维化增加,可使部分肝硬化大鼠汇管区及小叶间静脉壁纤维化;PVA对肝细胞的损害主要集中在术后4周内,待肝脏对新的血流动力学改变及其相应的影响达到稳态后,PVA对肝脏的损害则不明显。

Objective

To compare liver damage following portal vein arterialization (PCS) and portocaval shunt (PCS) in normal and cirrhotic rats.

Methods

One hundred cirrhotic rats were randomly divided into three groups: Group A (n=40), PVA+PCS; Group B (n=40), PCS only; Group C (n=20), portal vein blocking for 30 minutes plus right nephrectomy. Labeling index of inducible nitric oxide synthase (iNOS) was measured and analyzed before and 1, 2, 4, 8 weeks after the operation in each group respectively. Another 24 normal rats were randomly evenly divided into three groups. Collagenous fiber expression of each liver tissue was assessed by Masson trichrome stain and analyzed by Image-Pro Plus before and 4, 8 weeks after the operation.

Results

(1) Two (5%) cirrhotic rats were detected proliferation of fibrotic tissue at portal area by HE stain in Group A. (2) The cirrhotic rats showed the highest values of iNOS (SUM IOD: 600 583±32 828) before the operation, but they decreased obviously over time after surgery in the three groups (P<0.01) . However, the values of iNOS in Group A were significantly higher than the other two groups within postoperative 4 weeks (P<0.01) . Until 8 weeks postoperatively, there was no significant difference between Group A and the other two non-PVA groups. (3)There was no significant difference in the sum IOD of liver collagenous fiber expression gained from masson trichrome stain before the operation and the other two postoperative moments in normal rats.

Conclusions

The present findings indicate that PVA technique can not promote the expression of liver collagenous fiber in normal rats within postoperative 8 weeks. Proliferation of fibrotic tissue of portal area is found in 5% cirrhotic rats following PVA with PCS within postoperative 8 weeks. The most severe damages that PVA technique brings to the liver of cirrhotic rats are within postoperative 4 weeks, but they gradually become less obvious after the liver adapts to changes of blood dynamics.

图1 A:各组大鼠肝脏纤维化评分;B:大鼠肝硬化建模后肝脏,肝脏结节状增生明显;C:肝硬化大鼠PVA+PCS造模成功后的血管吻合口(黑箭头所指);D:A组术后8周:叶间静脉扩张、壁纤维增生增厚明显,汇管区明显扩张(HE ×100);E:叶间静脉正常的A组大鼠肝组织切片,无D图出现的现象(HE ×100)
图2 3组大鼠肝组织iNOS免疫组化照片总IOD值变化趋势图
图3 术前及各组术后肝细胞诱导型一氧化氮合成酶(iNOS)表达变化情况(免疫组化SP法×400)
表1 3组大鼠肝组织iNOS免疫组化总IOD值比较(±s
图4 正常大鼠术前及动脉化后肝组织间质蓝色胶原纤维稀少,术前、术后无明显变化(马松染色×400)
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