门静脉动脉化对肝硬化犬肝切除后肝再生的作用

Effects of portal vein arterialization on liver regeneration in hepatocirrhosis after partial hepatectomy in dogs

目的:探讨门静脉动脉化(portalveinarterialization,PVA)对肝硬化犬肝切除后肝再生的作用,为扩大PVA临床应用提供依据.方法:将肝硬化模型犬随机分为3组,A组(手术组):行肝左外叶切除加门静脉动脉化手术;B组(对照组):仅行肝左外叶切除手术;C组(假手术组);均于术后4wk处死,实验过程中检测肝脏再生率(SE)与动脉血酮体比(AKBR),免疫组织化学法检测增殖细胞核抗原(PCNA).结果:肝脏再生率SE值A组显著高于B组,两者有显著性差异(86.6%±2.9%vs73.7%±6.9%,P<0.01);术后A、B两组AKBR值均较C组降低(均P<0.01),术后4wkA组该值(1.32±0.14)已接近C组(1.33±0.11),差异无统计学意义P>0.05;术后PCNA表达A组显著快于B组.结论:门静脉动脉化对肝硬化犬部分肝切除后肝脏再生有明显的促进作用.

AIM： To study the effects of portal vein arterialization （PVA） on the liver regeneration in hepatocirrhosis after partial hepatectomy in dogs in order to provide a basis for its clinical use. METHODS： The liver cirrhosis model of dogs was established. The dogs were divided into three groups randomly： group A （PVA group）, partial hepatectomy plus PVA; group B （con- trol group）, partial hepatectomy; and group C, sham-operated group. All dogs were killed four weeks after operation. During the ex- periment, liver regeneration rate, expression of proliferating cell nuclear antigen （PCNA） in liver tissue and arterial ketone body ratio（AKBR） were observed. RESULTS： Liver regeneration rate was signifi- cantly higher in group A than in group B （86.6% ± 2.9% vs 73.7% ± 6.9%, P 〈 0.01）; the AKBR of groups A and B was significantly lower than group C （both P 〈 0.01）, but 4 wks after opera- tion, the AKBR of group A（1.32 ± 0.14） became close to group C （1.33 ± 0.11）, without significant difference （P 〉 0.05）; the expression of PCNA in liver tissues of group A was significantly faster than group B. CONCLUSION： PVA has significantly positive effect on liver regeneration after partial hepatec- tomy in dogs with hepatocirrhosis.