Ijaz Samia, Yang Wenxuan, Winslet Marc C, Seifalian Alexander M
University Department of Surgery, Royal Free and University College Medical School, University College London and the Royal Free Hospital, London NW3 2QG, UK.
Microcirculation. 2003 Dec;10(6):447-56. doi: 10.1038/sj.mn.7800206.
Fatty liver or hepatic steatosis, which is the result of the abnormal accumulation of triacylglycerol within the cytoplasm of hepatocytes, is a common histological finding in human liver biopsy specimens that is attributed to the effects of alcohol excess, obesity, diabetes, or drugs. There is a general consensus that fatty liver compromises hepatic microcirculation, the common exchange network upon which hepatic arterial and portal inflows converge, regardless of underlying etiology. A significant reduction in hepatic microcirculation has been observed in human fatty donor livers and in experimental models of hepatic steatosis. There is an inverse correlation between the degree of fat infiltration and both total hepatic blood flow and flow in microcirculation. Fatty accumulation in the cytoplasm of the hepatocytes is associated with an increase in the cell volume that reduces the size of the hepatic sinusoid space by 50% compared with a normal liver and may result in partial or complete obstruction of the hepatic sinusoid space. As a result of impaired hepatic microcirculation, the hepatocytes of the fatty liver have reduced tolerance against ischemia-reperfusion injury, which affects about 25% of the donors for liver transplantation because severe steatosis is associated with a high risk of primary nonfunction after liver transplantation.
脂肪肝或肝脂肪变性是肝细胞胞质内三酰甘油异常蓄积的结果，是人类肝脏活检标本中常见的组织学表现，其病因包括过量饮酒、肥胖、糖尿病或药物影响。人们普遍认为，无论潜在病因如何，脂肪肝都会损害肝微循环，肝微循环是肝动脉和门静脉血流汇聚的共同交换网络。在人类脂肪肝供肝和肝脂肪变性实验模型中均观察到肝微循环显著减少。脂肪浸润程度与肝总血流量及微循环血流量呈负相关。肝细胞胞质内的脂肪堆积与细胞体积增加有关，与正常肝脏相比，肝血窦空间大小减少50%，可能导致肝血窦空间部分或完全阻塞。由于肝微循环受损，脂肪肝的肝细胞对缺血再灌注损伤的耐受性降低，这影响了约25%的肝移植供体，因为严重脂肪变性与肝移植后原发性无功能的高风险相关。
