去胆管肝叶肝组织形态及功能变化的实验研究

An experimental study on histomorphological and functional changes in hepatic lobe with deprivation of bile duct

目的观察大鼠肝叶胆管栓塞结扎后肝细胞形态及功能的变化,探讨去胆管肝叶的保留价值。方法应用氰基丙烯酸酯对仅保留肝右叶和方叶的大鼠行右叶胆道栓塞并结扎,制备去胆管肝叶,肝方叶不处理或行门静脉结扎作去门脉肝叶自身对照。通过分肝静脉血化验检查、组织学观察探讨肝细胞形态及功能的变化。结果与假手术对照组及自身未处理肝叶相比,去胆管肝叶萎缩不明显,超微结构变化不大。透射电镜观察发现去胆管肝叶肝细胞富含线粒体、核糖体及粗面内质网。PAS染色显示肝糖原代谢也无明显差别。分肝静脉血白蛋白及纤维蛋白原含量无明显减低。结论去胆管肝叶在观察期内无明显纤维化,仍保留有肝细胞蛋白质合成、分泌及营养物质代谢功能,提示去胆管肝叶具有保留价值。本实验为临床特殊情况下结扎或切除胆管而保留相应的肝脏组织提供了理论基础。

Objective To investigate the residual functions in the hepatic lobe with deprivation of bile duct by observation of histomorphological and functional changes in the hepatic cells in a rat model Methods The right hepatic bile ducts of rats were obstructed with cyanoacrylate and then ligated two weeks after the left and caudate lobes were removed. The lobus quadratus hepatis served as self-control with or without portal vein ligatiorL The venous blood from individualized liver lobe was examined and histological observation was done to examine the histomorphological and functional changes in the hepatic cells. Results Compared to the controls of both sham operation and untreated lobe, the hepatic lobe with bile ducts deprived did not undergo atrophy significantly with few ultrastructural changes The hepa- tocytes of the hepatic lobe with bile duct deprived contained plenty of mitochondria, ribosomes and rough endoplasmic reticulum when observed under transmission electron microscope （TEM）. The results of periodic add-Sehiff staining revealed normal glycogen metabolism in the hepatic cells. No significant decrease was detected in the serum albumin and fibrinogen concentrations by examination of blood collected from vein of this liver lobe with deprivation of bile ducts. Conclusions The liver lobes with bile ducts deprived retain roost of the liver functions such as protein synthesis and nutrition metabolism, and show no atrophy during the observation period. It is suggested that the hepatic lobes with bile duct deprived still possess the value of preservation. The present study has founded a theoretic basis for remaining the remaining liver lobes with bile duct deprived or ligated in some emergency and specific clinical situations.