肝细胞凋亡与肝储备功能的关系

摘要：目的:探讨肝细胞凋亡对评价肝储备功能的意义。方法:54例肝切除手术患者，包括（1）对照组：肝血管瘤10例；（2）肝病组：肝癌32例和肝内胆管结石12例，肝病组中肝硬化24例（肝硬化组），无肝硬化20例（非肝硬化组）。术中取肝组织检测肝硬化和细胞凋亡。依据细胞凋亡指数（AI）在肝硬化组总体均数的95％可信区间下限值分2组： AI<0.0381组和AI≥0.0381组。分析AI与肝硬化和术后肝功能恢复情况的关系。结果:肝病组AI明显高于对照组（P=0.000）。肝病组中肝硬化组AI(0.046±0.022)显著高于非肝硬化组(0.026±0.021)（P<0.05）。AI预测术后肝功能恢复情况的符合率（准确度）为79.55%，Child分级的符合率为59.09%，差异有显著性（P=0.0194及P=0.0285）。结论:肝细胞AI可作为反映肝功能损害的一个敏感指标；检测肝细胞凋亡水平较可靠地反映肝功能变化和储备能力。

The correlation between hepatocellular apoptosis and liver reserve function

Abstract:Objective:To investigate the significance of hepatocellular apoptosis in evaluation of liver reserve function.Methods:Analsis of 54 cases who underwent partial hepatectomy, including 10 cases of hemangioma of liver (control group), and 44 cases of hepatopathy (32 cases of liver cancer and 12 cases of intrahepatic bile duct stone, hepatopathy group), including 24 cases of liver cirrhosis(cirrhosis group)and 20 cases with no liver cirrhosis (non-cirrhosis group) . At operation, liver tissue was taken for determination of cirrhosis and apoptosis. In cirrhosis group, 2 groups were divided according to the 95% confidence interval of apoptosis indexes（ AI<0.0381 group，AI≥0.0381 group）. Cirrhosis and the degree of recovery of hepatic functions at postoperation were analysed and compared with hepatocellular AI.Results:AI in the hepatopathy groups were significantly higher than control group(P=0.000), AI in the cirrhosis groups(0.046±0.022) were significantly higher than non-cirrhosis groups(0.0267±0.021) (P<0.05). The accuracy rate of AI for predecting the liver reserve function was 79.55%, and was significantly higher than that of Child class（P=0.05）. Conclusions:AI of hepatic cells could serve as a sensitive indicator of hepatic function imparment, and can be for predicting change of liver function and liver reserve function.