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[大量肝切除术后亚致死性内毒素血症对肝网状内皮系统的影响]

[Effects of sublethal endotoxemia to the hepatic reticuloendothelial system after massive hepatectomy].

作者信息

Maruo H, Nakamura S, Muro H

机构信息

Second Department of Surgery, Hamamatsu University School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1991 Nov;92(11):1608-16.

PMID:1770933
Abstract

Sublethal doses (1mg/kg) of endotoxin (ET) were intravenously administered on the first, third and fifth days after 34%, 70%, and 84% hepatectomies in rats. The same hepatectomy groups of rats without ET administration were made. Survival rates, distribution of Kupffer cells (Kc), regeneration rate of the liver weight, carbon clearance test (K value) and PTAH staining were compared between ET treated and untreated groups. Survival rates of 84% hepatectomy rats with ET injection on the 3rd postoperative day (POD) was significantly lower than those of 70% hepatectomy rats with ET on the 1st or 3rd POD. ET activated reticuloendothelial function of the non-hepatectomized and 34% hepatectomy rats, but reduced the number of the Kc in the central zone, especially in 84% hepatectomized rats. K values and the number of Kc in the central zone showed a good correlationship (r = 0.9) after 70% and 84% hepatectomies. Patchy hepatic necrosis and fibrin clots were observed histologically in the liver, kidney and spleen of rats died after ET administration. In conclusion, sublethal endotoxemia reduces the function and number of Kupffer cells in the regenerating liver and causes postoperative death in the rats with massive hepatectomy.

摘要

在大鼠进行34%、70%和84%肝切除术后的第1天、第3天和第5天,静脉注射亚致死剂量(1mg/kg)的内毒素(ET)。制作相同肝切除组但未注射ET的大鼠作为对照。比较ET处理组和未处理组的生存率、库普弗细胞(Kc)分布、肝脏重量再生率、碳清除试验(K值)和PTAH染色。术后第3天(POD)注射ET的84%肝切除大鼠的生存率显著低于术后第1天或第3天注射ET的70%肝切除大鼠。ET激活了未肝切除和34%肝切除大鼠的网状内皮功能,但减少了中央区Kc的数量,尤其是在84%肝切除大鼠中。70%和84%肝切除术后,中央区的K值和Kc数量呈现良好的相关性(r = 0.9)。在注射ET后死亡的大鼠的肝脏、肾脏和脾脏中,组织学观察到散在性肝坏死和纤维蛋白凝块。总之,亚致死性内毒素血症会降低再生肝脏中库普弗细胞的功能和数量,并导致大鼠在大规模肝切除术后死亡。

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