门静脉动脉化后大鼠门静脉血液动力学改变对肝脏功能的远期影响

Hemodynamic changes of portal vein and its long-term effects on liver function after portal vein arterialization in rats

目的 :探讨大鼠门静脉完全动脉化 (PVA )后门静脉血液动力学的变化对肝脏功能的远期影响。方法 :将大鼠分为 PVA组和对照组 ,PVA组大鼠行肝总动脉与近肝段门静脉端侧吻合 ,远肝段门静脉与腔静脉侧侧吻合 ,建立大鼠门静脉完全动脉化模型 ,对照组开腹后行肝门部游离后关腹。观察两组术后 1及 6个月门静脉血流量、横截面积以及术后 6个月门静脉压力及肝脏结构和功能的变化。结果 :与对照组比较 ,术后 1及 6个月 PVA组门静脉横截面及血流量增加 (P<0 .0 5 ) ,术后 6个月两组大鼠血浆内毒素、门静脉压力以及血清白蛋白、胆汁酸盐、直接胆红素和总胆红素水平差异无显著性 (P>0 .0 5 )。 PVA组大鼠血清 GPT水平显著升高 (P<0 .0 5 ) ,其肝中门静脉及其分支壁扩张增厚、胶原含量增加。结论 :未采取限流措施的门静脉动脉化可导致门静脉横截面积和血流量增加 ,门静脉分支扩张、管壁增厚 ,但网状内皮系统的吞噬功能以及胆色素和胆盐的代谢未受显著的影响。

Objective To investigate the long-term effects of portal vein hemodynamic changes on liver function after portal vein arterialization(PVA) in rats. Methods The rats were divided into PVA group and control group. The common liver artery was anastomosed with the proximal portal vein by end-side way, and the distal portal vein with the vena cava by side-side way in PVA group for the sake of establishing the models of rat PVA. The abdominal cavity was closed after dissociating the liver hilar tissue in control group.The blood flow volume and cross section in two groups operated for one month and six months ,respectively, were observed. The portal vein pressure, liver function and structure after six months were observed. Results Compared with control group, the cross section and blood flow volume of portal vein had a increasing trend in PVA group(P<0.05).Portal vein pressure,the levels of plasma endotoxin,serum albumin,bile acid salt,DBIL and TBIL didn′t present distinct difference(P>0.05). But the level of serum GPT in PVA group increased evidently(P<0.05),and the walls thickened and the proportion of collagen increased in distended portal vein and its branches. Conclusion The PVA without limiting the blood flow volume can increase the cross section and blood flow volume of portal vein ,dilate and thicken the branches of portal vein, but the function of reticuloendothelial system, metabolism of bile pigment and bile acid salt don′t undergo significant influences.