大鼠70%肝切除后门静脉血流动力学变化及其与肝再生关系初探

目的 初步探究大鼠70%肝切除（PH）后门静脉血流动力学变化及其与肝再生的关系。方法 将大鼠随机分为假手术组和70%PH组，于术前及术后第1、3、7、14天采用5.0~12.0 MHz高频超声探头测量门静脉主干管径（PVD）及最大血流速度(PVV)；并观察肝组织形态学变化及细胞增殖核抗原（PCNA）表达, 计算肝脏再生率（LRR）。结果 大鼠70%PH术后第1天，PCNA开始升高，肝细胞以空泡样变为主，肝窦受压变窄，PVD增粗, PVV减慢；第3天，肝细胞达核分裂高峰期，PCNA达峰值，肝窦结构紊乱，PVD达峰值而PVV降至最低；术后第14天，肝细胞形态和肝小叶结构逐渐恢复，PCNA恢复至假手术组水平，LRR增至90%以上，同时，PVD、PVV均恢复至假手术组水平（P>0.05）。结论 大鼠PH后血流动力学参数PVD、PVV与肝细胞的病理改变、核分裂状态、再生肝脏体积等因素有关，为超声应用于临床监测肝细胞再生的深入研究提供了基础依据。

A Preliminary Study on Portal Vein Hemodynamic Changes and Liver Regeneration in Rats after 70% Partial Hepatectomy

Objective To explore portal vein hemodynamic changes and liver regeneration in rats after 70% partial hepatectomy (PH). Methods Rats were randomly subjected into sham operation group and 70%PH group. A 5-12 MHz high-frequency linear transducer was applied to measure the portal vein diameter (PVD) and the maximum portal vein velocity (PVV) before and after operation on day 1, 3, 7, 14. On the corresponding time, liver tissue morphological changes were observed, and the expression level of PCNA was measured, and the liver regeneration rate (LRR) was calculated. Results On day 1 after PH, PCNA began to increase, and hepatocyte vacuolated obviously which squeezed and narrowed the hepatic sinusoid. Meanwhile, PVD started to dilate and PVV decelerated. On day 3 after operation, PCNA peaked and active mitosis resulted in the disorders of hepatic structure. PVD peaked and PVV decelerated to the lowest. Until the 14 d after operation, the cell morphology, lobular structure and PCNA recovered gradually accompany by LRR above 90%. PVD and PVV also almost recovered to levels closed to sham group (P<0.05). Conclusion The hemodynamic parameters PVD, PVV correlated with hepatic pathology changes, mitosis status and regenerated liver volume after PH, which state the potential possibility for ultrasound image study in liver regeneration surveillance.