人工肝支持系统治疗急性肝衰竭的病理研究

目的研究人工肝支持系统(ALSS)治疗急性肝衰竭的效果。方法将11只实验小型猪分为治疗组(n=6)和对照组(n=5),均给予D-氨基半乳糖,建立急性肝衰竭模型;治疗组48 h后经人工肝血浆置换结合血液滤过联合治疗。观察2组的一般情况、生存时间、生化指标和肝脏病理学变化。结果治疗组经人工肝治疗72 h后,一般状况有所改善,生存时间为(128.7±11.3)h,与对照组〔(67.9±9.4)h〕相比差异有统计学意义(P<0.01)。治疗组的丙氨酸转氨酶(ALT)、总胆红素(TBil)、凝血酶原时间(PT)与同组治疗前和对照组相比均有明显改善(P<0.01)。2组增殖细胞核抗原(PCNA)的阳性表达率比较差异有统计学意义(P<0.05)。治疗组与对照组的HE染色标本相比,肝脏坏死区域明显缩小,未发现明显淤胆。结论人工肝治疗急性肝衰竭效果显著,可以减少坏死区,提高肝细胞再生率,延长存活时间。

Studies on the Pathophysiological Performance of the Artificial Liver Support System in the Treatment of Acute Liver Failure

Objective To study the therapeutic effects of artificial liver support system treatment for in acute liver failure.Methods Eleven miniature pigs were divided into the therapeutic and control groups.Pigs were given D-galactosamine to build models of acute liver failure.Pigs in the therapeutic group were treated after 48 h with plasma exchange and hemofiltration of the artificial liver support system(ALSS).Four parameters were observed: survival time,common condition,biochemical assay,changes in liver pathology.Results The survival time(128.7±11.3) h in the therapeutic group were remarkably different from those in the control group(67.9±9.4)h in terms of improvements in the common condition,as well as ALT,TBil and PT levels(P<0.01).Area of necrosis was obviously reduced in the therapeutic group,and cholestasis was not found.Conclusion Treatment of acute liver failure by ALSS in pig model is very effective.