肝硬化大鼠门静脉高压症不同手术方式对其肝脏的影响

Effects of different operations on cirrhotic portal hypertensive liver in rats

目的:评价门奇断流术(PAD)、肠腔分流术(MCS)、远端脾腔分流术(DSCS)对门体分流率(PSS)、肝脏功能、线粒体功能和抗氧化能力的影响,为合理选择手术方式提供理论依据. 方法:用CCl4/乙醇诱导大鼠肝硬化门脉高压症模型,观察了不同术式(MCS、DSCS、PAD)的死亡率及手术前后肝功能、门体分流率(PSS)、肝细胞线粒体功能和超微结构及肝组织SOD活性、巯基水平、LPO含量的变化,并探讨了线粒体功能与抗氧化能力的内在关系. 结果:肝硬化门脉高压时,PSS远高于正常,肝细胞线粒体功能、抗氧化能力均下降;肠腔分流(MCS)组术后肝细胞线粒体功能、抗氧化能力进一步下降且恢复慢;选择性远端脾腔分流术(DSCS)组和门奇断流术(PAD)组的上述指际变化小且恢复较快,其中DSCS组恢复更快且死亡率低. 结论:选择性分流术(DSCS)

AIM: To evaluate respectively the effects of portaazygous disconnection (PAD), mesocaval shunt (MCS) and distal splenocaval shunt (DSCS) on the portasytemic shunting (PSS), hepatic function (HF), hepatic mitochondrial respiratory function (HMRF) and its ultrastructure, anti-oxidation ability (HAOA) and lipoperoxide (LPO), so as to provide theoretical basis to select a suitable operation. METHODS: Using the cirrhotic portal hypertensive model induced by CCI4/ethanol in Wristar rats, we investigated PSS, HF, HMRF and its HAOA and LPO during three weeks after MCS, DSCS and PAD. RESULTS: After MCS, the PSS were further increased, HF, HMRF and HAOA were significantly decreased, and LPO increased. Hepatic mitochondrial ultrastructure showed severely damaged. Only a little improvement was found on the third week. After DSCS and PAD, above mentioned indexes were less influenced, and they were restored a little more quickly in DSCS groups than that in PAD groups. During the first postoperative week, the PAD group showed the highest mortality. CONCLUSION: DSCS may be a desirable operation among the three kinds of operation.