门腔分流术后经门静脉输入肝营养因子对肝功能的保护作用

Experimental study of protective effects of hepatotrophic factors on hepatic functions in rats with portal hypertension after portacaval shunt

目的 观察肝硬变、门静脉高压症大鼠接受门腔分流手术后,经门静脉输入肝营养因子（促肝细胞生长素、胰岛素）对肝脏功能、病理改变及纤维化程度的影响.方法 肝硬化门静脉高压大鼠随机数字表法分人正常对照组、肝硬变模型组、生理盐水（NS）治疗对照组、促肝细胞生长素（HGF）治疗组、胰岛素（INS）治疗组、促肝细胞生长素＋胰岛素（HGF＋INS）治疗组.各治疗组大鼠行门腔静脉端侧分流术后给予相应肝细胞营养因子,治疗结束时,取血测定肝功能,取肝组织进行肝硬化分级.结果 血清丙氨酸转氨酶（ALT）：HGF治疗组（42.0±9.5）U/L、HGF＋INS治疗组（30.1±4.1）U/L明显低于NS组（56.5±12.4）U/L;天门冬氨酸转氨酶（AST）：HGF治疗组（172.9±42.8）U/L、HGF＋INS治疗组（133.7±21.2）U/L明显低于NS组（266.9±81.5）U/L;血清透明质酸（HA）：HGF治疗组（435.4±127.7）μg/L、HGF＋INS治疗组（322.5±52.3）μg/L明显低于NS组（563.0±146.4）μg/L,层粘连蛋白（LN）较NS组明显降低（均P＜0.05）;各治疗组肝脏纤维化评分、Masson染色胶原沉积面积均较NS治疗对照组明显降低（均P＜0.01）.结论 肝硬变大鼠接受门腔分流手术后,经门静脉输入肝营养因子（促肝细胞生长素＋胰岛素）可以有效的改善大鼠的肝功能及肝细胞损害,并在一定程度上改善¨静脉高压大鼠的肝脏纤维化程度.

Objective To investigate the protective effects of hepatotrophie factors （hepatocyle growth-promoting factor and insulin） on hepatic functions and pathology in rats with portal hypertension after portacaval shunt. Methods The rats of hepatic cirrhosis with portal hypertension were randornly assigned into 1 control group, 1 model group and 4 treatment groups （NS, HGF, INS, IIGF ＋ INS）. An end-side portacaval shunt was performed in the treatment group. The hepatotrophie factors were respectively injected into portal vein. After treatment, the serum levels of ALT （alanine aminotransferase） , AST （aspartate aminotransferase）, ItA （hyalurunie acid） and I.N （laminin） were determined by radioimmunoassay. Anti then according to the hematoxylin and eosin （H＆E） staining results, the tissue slides were prepared. Results The serum levels of ALT （30. 13 ±4. 12 U/L）, AST （133.75±21. 18 U/IJ, IIA （322.49±52. 33 ~L） and LN （23.89 ±5.03ug/L） were lower in the HGF ＋ INS group than those in the NS group （ all P 〈 0. 01 ） ; the scores of hepatic fibrosis stages （ 1.63 ± 0.74 ） and collagen semiquantitative of Massnn stain （ 10. 17 ± 1. 14 ×10^-2 ） were significantly reduced in the HGF ＋ INS group than lhose in the NS group （all P 〈 0.01 ）. Conclusion The injection of hepatotrophle factors through portal vein after portacaval shunt can improve hepatic functions, reduce the damages of hepatocyte and improve the degree of hepatic fibrosis.