门静脉动脉化加门腔分流对肝硬化大鼠肝储备功能的影响

目的研究入肝门静脉动脉化加门腔分流术对肝硬化大鼠肝脏储备功能的影响。方法 100只肝硬化大鼠随机分为A组（n=40）,入肝门静脉完全动脉化＋门腔分流;B组（n=40）,仅行门腔完全分流;C组（n=20）,门静脉阻断30min＋右肾切除。分别检测术前和各组大鼠术后1周、2周、4周及8周动脉血酮比（AKBR）及吲哚氰氯15min潴留率（ICGR15）。结果术后A组大鼠的AKBR较术前及B、C两组均有明显升高,差异有明显统计学意义（P〈0.01）,并于术后2周,可达到稳态;术后A组大鼠ICGR15较术前及B、C两组明显降低,差异也有统计学意义（P〈0.01）,并于术后2周可达到稳态。结论入肝门静脉动脉化能明显促进肝硬化大鼠肝脏储备功能恢复,有助于预防门腔分流术后肝衰竭。

Effects on hepatic reserve function following portal vein arterialization associated with portocaval shunt in cirrhotic rats

Objective To evaluate the effects on hepatic reserve function following portal vein arterialization （PVA） associated with portocaval shunt （PCS） in cirrhotic rats. Methods One hundred cirrhotic rats were randomly divided into three groups： Group A （n = 40）, PVA ＋ PCS; Group B （n = 40）, PCS only; Group C （n = 20）, portal vein block for 30 min ＋ right nephrectomy. The serum level of arterial ketone body ratio （AKBR） and ICGR15 was measured at the moment of pre-operation, postoperative 1 week, 2 weeks, 4 weeks and 8 weeks in each group, respectively. Results The serum level of AKBR in Group A maintained a significant higher level than pre-operation and the other two groups （Group B and Group C） after surgery （P 0.01）. Otherwise, the serum level of ICGR15 in Group A was significantly lower than pre -operation and the other two groups （P 0.01）. The serum level of AKBR and ICGR15 reached a steady state in postoperative 2 weeks. Conclusions The PVA procedure brings beneficial effects on hepatic reserve function in cirrhotic rats. When associated with PCS, it may help to prevent liver failure.