经门静脉及肝动脉植入微囊对肝纤维化影响的对比研究
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A comparison study:liver fibrosis induced by microcapsules transplantation via portal vein and hepatic artery
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    摘要:

    目的:比较经门静脉及肝动脉两种途径肝内植入海藻酸钠微囊对肝纤维化影响的差别,探求一种更安全-更简便的胰岛植入途径-方法:实验犬30只随机分为A-V 2组,每组15只,分别作为经肝动脉植入组及经门静脉植入组,A-V两组各随机分为3个小组,每小组5只,分别植入海藻酸钠微囊8 000个/kg-16 000个/kg-32 000个/kg,观察植入前后血清肝纤维化标志物Ⅳ型胶原(CIV)的变化,并对肝脏进行病理组织学检查-结果:血清纤维化指标:V组:血清CIV值在植入后逐渐升高,植入前后有明显差别(P < 0.01);且各植入量组间存在显著性差异(P < 0.01)-A组:血清CIV值在植入后轻度升高,但植入前后无显著差异(P > 0.05),且各植入量组间的差异无统计学意义(P > 0.05)-相同植入量Vn及 An组间血清CIV值的比较差异有显著性(P < 0.01)-肝脏病理组织学检查:植入术后12周时,V3组肝脏组织学检查发现汇管区少量胶原纤维沉积,肝细胞浊肿,间质见炎性细胞浸润;而A组肝脏组织学检查未见明显异常-结论:植入量达到32 000个/Kg时,经门静脉植入可造成中远期肝损伤,导致肝纤维化;而经肝动脉植入对肝脏损伤小,将有望成为一种相对简单-安全的植入途径-

    Abstract:

    Objective:To compare the liver fibrosis induced by microcapsules transplantation via portal vein(group V) and hepatic artery(group A). Methods:Thirty dogs in this experiment were randomly divided into two groups:group A(microcapsules implanted into hepatic artery by hepatic artery catheterization) and group V(microcapsules implanted into portal vein by percutaneous transhepatic approach guided by ultrasound). And three sub groups of unequal microcapsules(8 000/Kg,16 000/Kg and 32 000/Kg) were given to both group A and group V respectively, each to five dogs. The main serum liver fibrosis indexe type Ⅳ collagen(CIV) was measured before and after the transplantation. Samples of the livers were examined pathologically before and after the operation. Results:In group V, C IV elevated gradually, and the values were significantly different from the pretransplant’s(P < 0.01). In group A, CIV showed no significant difference before and after transplantation(P > 0.05). The difference between group Vn and An was significant(P < 0.01). In group V3, some pathogenic changes indicating liver fibrosis were found in the hepatic sections stained with HE at 12 weeks’ post-transplant, but none in group A, and the structure of lobule remained normal at 12 weeks’ post-transplant in the latter. Conclusion:When the quantity of microcapsules was 32 000/kg, changes of serum liver fibrosis indexes and pathological liver such as liver fibrosis could be found in group V at 12 weeks’ after transplantation, while microcapsules transplantation via hepatic artery can avoid the damage of liver. Compared with via portal vein, via hepatic artery microcapsules transplantation avoided risks of liver damage in some degree, and thus can be regarded as a relatively safe and simple approach of transplantation of islet cells into the liver.

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段芙红,姜建威,刘 晟,王 维.经门静脉及肝动脉植入微囊对肝纤维化影响的对比研究[J].南京医科大学学报(自然科学版),2009,29(2):190-

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  • 收稿日期:2008-09-10
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