大鼠部分胃切除对残肝再生影响的实验研究

Experimental study of the affection of partial gastrectomy on remanent liver regeneration in rats

目的探讨大鼠部分胃切除对残肝再生的影响。方法选用雄性SD大鼠54只,随机分成68%肝叶切除组(A组:n=18),68%肝叶切除并70%胃体部切除组(B组:n=18),68%肝叶切除并胃窦部切除组(C组:n=18)。各组分别于术后24h,48h,72h分批处死,取肝后称肝重,测肝再生指数,10%福尔马林溶液固定肝脏,HE染色后测肝细胞分裂指数、免疫组化法测肝细胞PCNA(增殖细胞核蛋白抗原)指数。结果 (1)24h、48hB组术后肝再生率较低,与A组相比,有非常显著性差异(P<0.01);两组72h肝再生率有显著性差异(P=0.031)。而C组术后肝再生率在不同时间点明显偏低,和A、B组比较,均有非常显著性差异(P<0.01)。(2)B组术后24h肝细胞分裂指数、残余肝组织PCNA标记指数较低,与A组相比,有非常显著性差异(P<0.01);两组分别在48h、72h比较,无显著性差异(P>0.05)。而C组术后肝细胞分裂指数、残余肝组织PCNA标记指数在不同时间点明显降低,均有非常显著性差异(P<0.01)。结论 70%胃体部切除后大鼠残肝再生延迟,胃窦部切除后大鼠残肝再生明显受抑,部分胃切除同时不宜行肝大部切除。

Objective To explore the liver regeneration condition following majior liver resection combined with different types of partial gastriectomy. Methods Fifty-four male Sprague-Dawley rats were randomized equally into three groups： （A）68% of the liver was resected ,（B）68% of the liver was resected with 70% of the gastric body removed,（C）68% of the liver was resected with the gastric antrum removed.Six rats in each group were sacrified for liver tissue samples on the 24h ,48,h 72h postoperative hour respectively;Residual liver was weighed ,fixed with 10% formalin, stained with H-E. Regeneration rate （RR） and Mitotic index（MI） of liver were examined and Proliferating cell nuclear antigen （PCNA） labeling index of hepatocyte was investigated immunohistochemically. Results （1）RR at 24h,48h in group B was obviously slower than that of group A respectively （P〈0.01）,difference of the values at 72nd h between them was statistically （P=0.031）.The values of RR ,MI and PCNA labeling index in group C at various time points were quite low,Compared with group A and group B,had significant differences （P〈0.01）. （2）The level of MI and PCNA labeling index in group B was lower than that in group A （P〈0.01）; And there were no statistical differences at 48h,72nd h between the two groups respectively（P〈0.05）.The levels of MI and PCNA labeling index in group C at various time points postoperatively were the lowest compared with the other two groups respectively （P〈0.01）.Conclusion The regeneration of liver is inhibited by resection of the gastric antrum combined with 68% hepatectomy（PH）in rats, retarded in the rats by 70% of the gastric body resected combined with 68 % PH, majior hepatectomy was unsuitable for partial gastrectomy at the same time.