ALPPS一期术后刺激残肝再生及其相关因素的研究

黄粲宸; 黄民; 肖乐; 王涛; 冯亚星; 汤礼军

doi:10.16016/j.1000-5404.201803122

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ALPPS一期术后刺激残肝再生及其相关因素的研究

基础医学 | 更新时间：2026-01-09

- ALPPS一期术后刺激残肝再生及其相关因素的研究
- Liver regeneration and related factors after first step of ALPPS surgery in SD rats
- 第三军医大学学报 2018年40卷第13期页码：1198-1204
- 作者机构：
  
  1.646000 四川泸州，西南医科大学临床医学院
  2.610083 成都，成都军区总医院全军普通外科中心
- 作者简介：
  
  [汤礼军，E-mail：13258198900@163.com TANG Lijun, E-mail: 13258198900@163.com
- 基金信息：
  
  国家临床重点专科(普通外科)项目(41732113)
- DOI：10.16016/j.1000-5404.201803122
  中图分类号： R-332;R364.33;R657.3
- 收稿：2018-03-16，
  
  修回：2018-04-10，
  
  纸质出版：2018-07-15
- 稿件说明：
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黄粲宸, 黄民, 肖乐, 等. ALPPS一期术后刺激残肝再生及其相关因素的研究[J]. 第三军医大学学报, 2018,40(13):1198-1204.

Canchen HUANG, Min HUANG, Le XIAO, et al. Liver regeneration and related factors after first step of ALPPS surgery in SD rats[J]. Journal of Third Military Medical University, 2018, 40(13): 1198-1204.
黄粲宸, 黄民, 肖乐, 等. ALPPS一期术后刺激残肝再生及其相关因素的研究[J]. 第三军医大学学报, 2018,40(13):1198-1204. DOI： 10.16016/j.1000-5404.201803122.

Canchen HUANG, Min HUANG, Le XIAO, et al. Liver regeneration and related factors after first step of ALPPS surgery in SD rats[J]. Journal of Third Military Medical University, 2018, 40(13): 1198-1204. DOI： 10.16016/j.1000-5404.201803122.

摘要

目的

通过建立联合肝脏分隔和门静脉结扎二步肝切除术模型(associated liver partition and portal vein ligation for staged hepectomy，ALPPS)来探讨骨髓来源肝血窦内皮祖细胞(bone marrow liver sinusoidal endothelial cell progenitor cells，BM SPCs)在ALPPS一期术后肝再生中的作用。

方法

选取180~200 g健康SD雄性成年大鼠72只，按照随机数字表法分为ALPPS组、门静脉结扎组(portal vein ligation，PVL)和假手术组，分别在术后1、2、4、7 d检测各组大鼠保留侧肝脏体质量比，血清HGF表达水平，肝脏组织BM SPCs表面标记物CD133、CD45、CD31，以及肝功能和肝组织病理学，并对结果进行统计分析。

结果

① 相比于PVL组，ALPPS组在术后Ki-67阳性细胞更多，保留侧肝脏体质量比更高(

＜0.05)；②ALPPS组血清中谷丙转氨酶、谷草转氨酶和总胆汁酸在术后第1天显著升高(

＜0.05)，第4天与PVL组比较，差异无统计学意义(

0.05)；③ALPPS组血清中的HGF在术后第1天达到峰值，明显高于PVL组，从第2天起开始下降，第4天开始有所回升(

＜0.05)；④ALPPS组结扎侧的BM SPCs表面标志物在术后1、2、4、7 d呈阳性，而ALPPS组的保留侧及其PVL组、Sham组均呈阴性。

结论

BM SPCs参与了ALPPS术后肝脏的快速再生。

Abstract

Objective

To establish a stable animal model of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS)

and to explore whether bone marrow liver sinusoidal endothelial cell progenitor cells (BM SPCs) participate in the regeneration of residual liver after the first step of ALPPS surgery.

Methods

A total of 72 SD rats (male

adult

weighing 180~200 g) were randomly divided to ALPPS group (

=24)

portal vein ligation (PVL) group (

=24) and sham operation group (

=24). At 1

4 and 7 d after the operation

the ratio of residual liver weight to body weight

serum level of hepatocyte growth factor (HGF)

liver expression of BM SPCs surface markers CD133

CD45 and CD31

and liver function and pathological changes were observed and detected

and the results were compared among the groups.

Results

① Compared with the PVL group

the ALPPS group had more Ki-67 positive cells and higher ratio of residual liver weight to body weight (

0.05). ②The serum levels of alanine aminotransferase (ALT)

glutamic-oxalacetic transaminease (AST) and total bile acid (TBIL) in the ALPPS group were increased significantly (

0.05) from the first day after surgery

and they had no differences with those of the PVL group at the 4th day (

0.05). ③ The serum HGF level in the ALPPS group reached

a peak in the first day after surgery

significantly higher than that of the PVL group (

0.05)

and then reduced at the second day but slightly elevated from the 4th day (

0.05). ④Immunofluorescence assay showed that CD133

CD45 and CD31 were positive in the ligated side at 1

4 and 7 d after ALPPS operation

whereas were negative in the residual side

PVL group and Sham group.

Conclusion

BM SPCs take part in the rapid regeneration after ALPPS.

关键词

Keywords

references

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