门静脉动脉化加门腔分流对肝硬化大鼠肝功能的影响

Effects on Liver Function Following Portal Vein Arterialization Associated with Portocaval Shunt in Cirrhotic Rats

【目的】探讨入肝门静脉动脉化加门腔分流术对肝硬化大鼠肝功能的影响。【方法】125只肝硬化大鼠随机分为A组(n=50),入肝门静脉完全动脉化+门腔分流;B组(n=50),仅行门腔完全分流;C组(n=25),门静脉阻断30 min+右肾切除。分别检测各组大鼠术前、术后1、2、4及8周血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)、白蛋白(ALB)及吲哚氰氯15 min潴留率(ICGR15)。【结果】术前各组大鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)、白蛋白(ALB)及ICGR15无明显差异(P>0.05);术后随着时间推移,A组大鼠的ALT、TB、AST及ICGR15较B、C两组均有明显降低,差异有明显统计学意义(AST:P<0.05,其他指标P<0.01),并于术后2周后,可达到稳态;而A组ALB术后较B、C两组明显升高,差异也有显著统计学意义(P<0.01),并于术后4周可达到稳态。【结论】入肝门静脉动脉化重建入肝血流能明显促进肝硬化大鼠肝功能恢复,有助预防门腔分流术后肝功能衰竭。

[ Objective ] To evaluate the effects on liver function following portal vein arterializations （PVA） associated with portocaval shunt （PCS） in cirrhotic rats. [ Method ] A total of 125 cirrhotic rats were randomly divided into three groups： Group A （n= 50）, PVA＋PCS; Group B （n=50）, PCS only; Group C （n=25）, portal vein block for 30 min ＋ right nephrectomy. The serum level of alanine aminotransferase （ALT）, glutamic-oxalacetic transaminease （AST）, total bilirubin （TB）, albumin （ALB） and ICGR 15 was measured at the moment of pre-operation, postoperative 1 week, 2 weeks, 4 weeks, and 8 weeks in each group, respectively. [Results] No preoperative significant difference was observed in the serum level of ALT, AST, TB, ALB and ICGR 15 in three groups （P 〉 0.05）. The serum level of ALT, AST, TB, and 1CGR 15 in Group A maintain a significant lower level than the other two groups （Group B and Group C） after surgery （AST： P 〈 0.05, others：P 〈 0.01 ）. Otherwise, the serum level of ALB in Group A was significantly higher than the other two groups （P 〈 0.01）. The serum level of ALT, TB and ICGR15 reached a steady state in postoperative 2 weeks, and the serum level of ALB maintained stably untill postoperative 4 weeks. [ Conclusion ] The PVA procedure bring beneficial effects on liver function in cirrhotic rats. When associated with PCS, it should help to prevent liver failure.