Veteläinen R, Bennink R J, van Vliet A K, van Gulik T M
Department of Surgery, Surgical Laboratory, Academic Medical Centre, Amsterdam, The Netherlands.
Br J Surg. 2007 Aug;94(8):1002-8. doi: 10.1002/bjs.5672.
Mild steatosis has been thought not to affect outcome after liver resection. However, recent studies have reported impaired postoperative recovery of patients with mild steatosis. This study evaluated the recovery of hepatic functional reserve during regeneration in a rat model of mild steatosis and liver resection.
Male Wistar rats had a standard methione- and choline-deficient diet to induce mild steatosis before 70 per cent liver resection. Evaluation of hepatobiliary function was by (99m)Tc-labelled mebrofenin scintigraphy. Mebrofenin uptake rate, the time for maximum uptake (T peak) and the time required for peak activity to decrease by 50 per cent (T(1/2) peak) were assessed 1, 2, 3 and 7 days after liver resection, along with regeneration of the remnant liver, hepatocellular and sinusoidal damage, and hepatic adenosine 5'-triphosphate (ATP) levels.
Liver regeneration and proliferative response in mild steatotic rats were no different from those in controls. However, the mebrofenin uptake rate was lower (P < 0.050) and the recovery of hepatic ATP impaired (P < 0.050) in animals with mild steatosis. Hepatocellular damage was increased (P < 0.050) but sinusoidal endothelial cell function was not affected after liver resection in mildly steatotic rats.
Mild steatosis impaired functional recovery and increased hepatocellular damage after liver resection.
轻度脂肪变性一直被认为不会影响肝切除术后的预后。然而，最近的研究报道了轻度脂肪变性患者术后恢复受损。本研究在轻度脂肪变性和肝切除的大鼠模型中评估了肝脏再生过程中肝功能储备的恢复情况。
雄性Wistar大鼠在进行70%肝切除术前，采用标准的蛋氨酸和胆碱缺乏饮食诱导轻度脂肪变性。通过（99m）Tc标记的美布芬宁闪烁扫描评估肝胆功能。在肝切除术后1、2、3和7天评估美布芬宁摄取率、最大摄取时间（T峰）以及峰值活性降低50%所需的时间（T（1/2）峰），同时评估残余肝脏的再生、肝细胞和窦状隙损伤以及肝腺苷5'-三磷酸（ATP）水平。
轻度脂肪变性大鼠的肝脏再生和增殖反应与对照组无差异。然而，轻度脂肪变性动物的美布芬宁摄取率较低（P < 0.050），肝ATP的恢复受损（P < 0.050）。轻度脂肪变性大鼠肝切除术后肝细胞损伤增加（P < 0.050），但窦状内皮细胞功能未受影响。
轻度脂肪变性会损害肝切除术后的功能恢复并增加肝细胞损伤。
