胰岛素联合肝细胞生长因子对肝切除术后肝再生的促进作用

Insulin combined with hepatocyte growth factor improves posthepatectomy liver regeneration in rats

目的观察经门静脉联合灌注胰岛素和肝细胞生长因子是否比单一用药显著促进肝切除术后肝再生.方法将实验用新西兰兔随机分为胰岛素(insulin,INS)治疗组、肝细胞生长因子(hepatocyte growth factor,HGF)治疗组、联合用药组(INS+HGF)、对照组,行肝脏部分切除、门静脉置管,测定残肝体积,术后分别经门静脉置管微泵胰岛素、肝细胞生长因子、胰岛素和肝细胞生长因子、生理盐水,治疗结束时处死动物,测定肝脏体积,计算肝脏再生速度.术后监测肝功能、血清肿瘤坏死因子-a(tumor necrosis factora,TNF-a)、白介素-6(interleukin-6,IL-6).结果联合治疗组较对照组及胰岛素组、肝细胞生长因子组肝功能恢复快(P<0.01),肝细胞生长因子组和胰岛素组较对照组肝功能恢复快(P<0.05).术后残肝再生速度,胰岛素组和肝细胞生长因子组均较对照组快(P<0.05),联合用药组较对照组和单一用药组显著增快(P<0.01).实验组TNF-a、IL-6均较对照组升高,联合用药组较对照组和单一用药组统计学比较有显著性差异.结论经门静脉联合灌注胰岛素和肝细胞生长因子能显著促进肝切除术后肝再生.

AIM To investigate whether portal infusion of insulin combined with hepatocyte growth factor improves posthepatectomy liver regeneration in rats.METHODS Rats that underwent partial hepatectomy were assigned into an insulin group,a hepatocyte growth factor group,an insulin plus hepatocyte growth factor group,and a control group,which were treated with insulin alone,hepatocyte growth factor alone,insulin plus hepatocyte growth factor,and 0.9%sodium chloride via the portal vein,respectively.Liver volume,speed of liver regeneration,liver function,serum tumor necrosis factorα（TNF-α） and interleukin-6（IL-6） were measured after operation.RESULTS Recovery of liver function in the insulin plus hepatocyte growth factor group was faster than that in the insulin group and hepatocyte growth factor group（P 〈 0.01）.The speed of liver regeneration was slower in the control group than in hepatocyte growth factor group and insulin group,but was faster in the hepatocyte growth factor than in the insulin group and hepatocyte growth factor group.Serum levels of TNF-α and IL-6 were higher in the three treatment groups than in the control group,and in the hepatocyte growth factor and insulin group than in the hepatocyte growth factor group and insulin group.CONCLUSION Infusion of insulin and hepatocyte growth factor via the portal vein can significantly improve posthepatectomy liver regeneration.