完全梗阻性黄疸持续时间对大鼠肝切除术后肝再生的影响

Effect of Obstructive Jaundice of Different Degrees on the Liver Regeneration in Rats of Post-hepatectomy

目的探讨术前完全梗阻性黄疸的持续时间对大鼠肝切除术后肝再生的影响。方法建立完全梗阻性黄疸大鼠模型,测定梗阻不同时相的胆红素水平;选取梗阻0,1,3,7d分为4组,即正常肝切除组(A组)、梗阻1d肝切除组(B组)、梗阻3d肝切除组(C组)及梗阻7d肝切除组(D组),观察肝切除(肝切除量约70%)术后各组大鼠死亡率,检测肝切除术后0,12,24,48,72,168h的肝功能指标,免疫组织化学检测残肝组织PCNA标记指数,RT-PCR法检测肝组织HGF基因的表达,检测术后7d残肝质量/体质量的比值。结果B组在肝切除术后死亡率、肝功能恢复、PCNA标记指数、HGF mRNA表达及肝质量/体质量的比值等方面均优C组及D组,差别均有统计学意义(P<0.05)。结论术前高胆红素血症可明显抑制大鼠肝切除术后的肝再生;术前梗阻时间短、胆红素处于较低水平,扩大肝叶切除术才可能相对安全地进行。

Objective To explore the effect of obstructive jaundice of different degrees on the liver regeneration in rats of post-hepatectomy. Methods Rat models with obstructive jaundice were set up and used for evaluating bilirubin in different periods. A group, B group, C group and D group were estab- lished respectively in accordance with the level of bilirubin at 0, 1, 3 and 7 days. The rats then received hepateetomy（about 70% of total liver）. Mortality was thus followed. The observance of liver function was conducted at postoperative 0, 12, 24, 48, 72 and 168 hours, so were the study of PCNA index with immunohistological analysis, and HGF mRNA expression in remnant liver tissues. The ratio of the remnant liver＇s weight against body weight at 7 days after operation was also collected. Results Af tectomy, compared with C group and D group, the mortality, serum liver function, PCNA index ter hepawith immunohistological analysis, HGF mRNA expression in remnant liver tissues and the ratio of the remnant liver＇s weight against body weight were significantly different （P〈0.05） in rats of B group. Conclusion Hyperbilirubinemia caused by biliary obstruction before operation obviously inhibits the liver regeneration of post-hepatectomy. Hepatectomy is considered relatively safe only when a relatively low level of preoperative bilirubin and short-termed obstruction are achieved.