摘要
目的观察联合门静脉结扎及原位肝脏离断二步肝切除（ALPPS）对肝硬化大鼠肝脏再生能力的影响。方法将60只肝硬化SD大鼠随机分为3组。C-ALPPS组（n=20）：建立肝硬化模型后行ALPPS；C-PVL组（n=20）：建立肝硬化模型后行选择性门静脉结扎（PVL）；C-sham组（n=20）：建立肝硬化模型后行假手术。另取60只正常sD大鼠随机分为3组。N-ALPPS组（n=20）：正常大鼠行ALPPS；N-PVL组（n=20）：正常大鼠行选择性门静脉结扎；N-sham组（n=20）：正常大鼠行假手术。比较各组术前及术后未结扎侧／全肝肝重比、肝功能、未结扎侧细胞核增殖抗原（Ki67）表达的变化。结果肝硬化大鼠除假手术组外，术后第4、7天未结扎侧肝重比值均低于正常组，差异有统计学意义（P〈0．05）。C-ALPPS组与N-ALPPS组术后第4、7天未结扎侧／全肝肝重分别为（54．3±3．1）％比（61．2±2．1）％、（65．0±4．1）比（79．2±1．1）％；C-PVL组与N-PVL组术后第4、7天未结扎侧／全肝肝重分别为（52．4±1．8）％比（56．6±2．0）％、（63．8±3．1）比（70．0±2．5）％。C-ALPPS组与C．PVL组各时间点结扎侧肝重比值的差异均无统计学意义（P〉0．05）。肝硬化大鼠各组肝酶显著高于正常大鼠各组，白蛋白水平显著低于正常大鼠各组（均P〈0．05）。C-ALPPS组与N-ALPPS组术后第2、4、7天未结扎侧胞核增殖抗原分别为（19．4±4．8）％比（84．1±8．9）％、（33，6±3，5）％比（70．2±7．2）％、（20．2±2．5）％比（50．7±4．4）％；C-PVL组与N-PVL组术后第2、4、7天未结扎侧胞核增殖抗原分别为（21．1±4．0）％比（52．1±7．3）％、（32．4±5．9）％比（35．6±5．3）％、（15．5±4．6）％比（12．2±4．9）％。C-ALPPS与C．PVL术前、术后第2、4天未结扎侧胞核增殖抗原的比较的差异无统计学意义（P〉0．05）。结论在正常大鼠
Objective To observe the effects of associating liver partition with portal vein ligation for staged hepatectomy （ALPPS） on liver regeneration of the unligated lobe with cirrhosis. Methods 60 liver cirrhosis SD rats were randomly divided into three groups： C-ALPPS group （n = 20, liver cirrhosis ＋ ALPPS） , C-PVL group （ n = 20, liver cirrhosis ＋ PVL） and C-Sham group （ n = 20, liver cirrhosis ＋ sham operation）. 60 normal SD rats were randomly divided into three groups： N-ALPPS group （n = 20, normal liver ＋ PVL）, N-PVL group （n =20, normal liver ＋ PVL） and N-Sham group （n =20, normal liver ＋ sham operation）. The weight ratio of unligated lobes/total liver, proliferating cell nuclear antigen （ Ki-67 ） and liver function were compared before operation and 2, 4 and 7 days after operation. Results Except for sham operation group, liver weight ratios of unligated livers on the 4th and 7th days after operation were lower than those in the normal group （ P 〈 0.05 ）. The weight ratios of unligated lobes/total liver in C-ALPSS group and N-ALPPS group on 4th and 7th day postoperation were （ 54. 3 ± 3.1 ） % vs. （ 61.2 ±2. 1 ） % , （ 65.0 ±4. 1 ） % vs. （79. 2 ±1.1 ） %. The weight ratio unligated lobes/total liver in group C-PVL and group N-PVL at 4th and 7th day postoperation were （52.4 ± 1.8） % vs. （56. 6 ± 2.0） %, （63.8 ± 3.1 ） % vs. （70. 0 ± 2. 5）%. There was no significani difference on weight ratio of unligated lobes/total liver between C-ALPPS group and C-PVL group at each time point （ P 〈 0. 05 ）. There was significant difference on the alanine transaminase （ALT）, aspartate aminotransferase （AST） and albumin （ALB） levels between cirrhosis group and normal group at 4 and 7 days after operation （P 〈 0. 05 ）. The expression level of Ki-67 in cirrhosis group was significantly lower than that in normal group at each time point （ P 〈 0. 05 ）. The expression level of Ki-67 in group C-ALPSS and group N-ALPP
作者
肖遵强
黄静
于茜
张孔亮
熊超杰
陆才德
Xiao Zunqiang;Huang Jing;Yu Xi;Zhang Kongliang;Xiong Chaojie;Lu Caide(School of Medicine,Ningbo University,Ningbo 315000,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2018年第7期476-480,共5页
Chinese Journal of Hepatobiliary Surgery
基金
宁波市科技项目（2015A610209）
关键词
肝硬化
联合门静脉结扎及原位肝脏劈离
肝脏再生
Cirrhosis
Associating liver partition with portal vein ligation for staged hepatectomy（ALPPS）
Liver regeneration
