大鼠选择性门静脉栓塞的实验研究

Experimental Studies on Selective Portal Vein Embolization

目的研究选择性门静脉栓塞的作用及安全性。方法用α—氰基丙烯酸正辛酯选择性栓塞SD大鼠的门静脉左支 ,分别于术后1、3、7、14、30d处死 ,与正常大鼠比较 ,进行大体、组织学及增殖细胞核抗原染色观察 ,并检测血常规和肝功能。结果被栓塞肝叶大片坏死、纤维化、萎缩 ,术后30d由栓塞前占全肝重70 %降至8 % (P<0.01)。未栓塞肝叶代偿性肥大 ,术后30d重量达术前的3倍 ,门静脉分支扩张 ,肝细胞增生活跃 ,增殖细胞核抗原标记指数术后第1d升至术前水平的4.3倍 (P<0.01) ,术后30d降至术前水平。血常规无明显变化 ,肝功能呈一过性改变 ,主要为转氨酶升高 ,2周内恢复正常。结论选择性门静脉栓塞可使被栓塞肝叶明显萎缩而未栓塞肝叶代偿性增生肥大 ,效果安全可靠 ,为进一步用于临床肝癌治疗提供了实验依据。

Objective To study efficacy and safety of selective portal vein embolization (SPVE) on rats.Methods SD rats were killed 1,3,7,14,30 days respectively after embolization of the left portal vein branches with cyanoacrylate as compared with control group. Livers were removed, weighed, grossly and microscopically observed. Proliferative cell nuclear antigen labeling index (PCNA LI) was measured in the nonembolized lobes. Liver function was tested.Results Massive necrosis, fibrosis and atrophy were observed in the embolized lobes, the liver weight of which decreased from 70% to 8% of the whole liver 30 days after SPVE(P<0.01).Extension of the portal branches and proliferation of hepatocytes were the main histopathologic changes in the nonembolized lobes. PCNA LI was 4.3 times as normal level on the first day after SPVE(P<0.01). Transient elevations in serum aminotransferase levels were noted, but returned to normal 14 days after operation.Conclusions SPVE induced atrophy of the embolized lobes and compensatory hypertrophy of the nonembolized lobes of liver. It can be used effectively and safely as one of the therapeutic means for liver cancer.