门静脉分支栓塞联合肝细胞生长因子应用对肝硬化肝脏再生的实验研究

Experimental study of combined portal vein embolization with hepatocyte growth factor injection in liver regeneration in hepatic cirrhosis

目的:探讨兔门静脉栓塞(portal vein embolization,PVE)联合肝细胞生长因子(hepatocyte growth factor,HGF)应用对肝纤维化模型肝脏再生的作用。方法:20只肝纤维化新西兰大白兔模型,随机分为两组(HGF组,对照组),每组各10只。两组动物均以碘化油无水乙醇乳剂施行保留右下叶门静脉的门静脉栓塞。HGF组在PVE后经门静脉及术后3天经腹腔注射HGF,对照组在PVE后经门静脉及术后3天经腹腔注射生理盐水。PVE后连续随访4-5周,定期复查腹部CT检查,计算肝右下叶增生率。动物处死后行肝组织病理检查,所获数据行统计学分析处理。结果:两组动物PVE均获成功,处死前血管造影显示门静脉主干及部分分支再通。腹部CT检查显示,HGF组肝右下叶占全肝比率增长15.97±2.54%,对照组肝右下叶占全肝比率增长7.65±2.48%,两组间的增生率具有统计学上的显著性差异。结论:PVE联合门静脉及腹腔内注射HGF能明显促进未栓塞肝叶再生。

Objective： To evaluate the usefulness of combination PVE with HGF injection in liver regeneration after PVE in fibrotic rabbit model.Methods：Twenty hepatic fibrotic rabbit models were randomly divided into the HGF group （n = 10） and control group （n = 10）. PVE was peformed by using a combination of a mixture of absolute ethanol-lipodol in both group. For the HGF group, a bolus infusion of HGF was administered four times, at 0.5 h following PVE through the intraportal catheter, at 24, 48 and 72h following PVE by intra-peritoneal injection. Normal saline was injected using the same time schedule into the control rabbits. Regular examination of computed tomography and portal angiography were made. The degree of hypertrophy of non-embolized liver segment were compared. After the rabbits were sacrificed, the specimens were pathologically examined. All the data were statistically analyzed. Results： The PVE process was success in both group. In both groups, recanalization of some of the embolized portal branches could be seen. A 15.97% ± 2.54 hypertrophy of non-embolized liver was achieved in HGF group. The hypertrophy percentage of non-embolized liver was 7.65% ± 2.48 in the control group. Significant difference in hypertrophy percentage of non-embolized liver existed between two groups （ P 〈 0.05） .Conclusion： A more great degree of hypertrophy on non-embolized liver segment can be achieved by using HGF after portal vein embolization.