活体肝供者肝脏脂肪变性、肝脏体积与脾脏体积之间的相关性
Correlation between hepatic steatosis, hepatic volume, and spleen volume in live liver donors.
作者信息
Chen T-Y, Chen C-L, Tsang L L-C, Huang T-L, Wang C-C, Concejero A M, Lu C-H, Cheng Y-F
机构信息
Liver Transplant Program, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Taiwan.
出版信息
Transplant Proc. 2008 Oct;40(8):2481-3. doi: 10.1016/j.transproceed.2008.08.045.
INTRODUCTION
The purpose of this study was to evaluate the changes in liver fatty content and the volumes of liver and spleen after body weight reduction in potential living liver donors.
MATERIALS AND METHODS
Twenty-three potential living donors had fatty livers at pretransplantation sonography and computed tomography (CT). All were advised to undergo body weight reduction by exercise and diet control. A percutaneous core liver biopsy was performed in segment 5 of the liver in 22 donors to evaluate the hepatic fat content before and after body weight reduction. We compared the changes in the liver CT attenuation values and volume changes in the left and right lobes of the liver and the spleen before and after body weight reduction.
RESULTS
The mean (SD) body weight, body mass index, and fatty content of the liver biopsy specimens were 73 (17) kg, 26.8 (4.4), and 16.9% (12.7%), respectively, before body weight reduction and 70 (15) kg, 25.3 (3.8), and 6.6% (3.7%), respectively, thereafter. These changes were significant. The CT attenuation values of the left and right lobes of the liver and spleen were 54 (11), 51 (11), and 52 (5) HU, respectively, before body weight reduction and 60 (8), 58 (6), and 53 (5) HU, respectively, thereafter. The mean CT attenuation value of the left lateral segment was greater than that of the right lobe both before and after body weight reduction. The volume of the left and right lobes and spleen changed from 497 (129) cm3 to 452 (99) cm3, 927 (237) cm3 to 846 (173) cm3, and 185 (65) cm3 to 186 (63) cm3, respectively, thereafter. The right and left lobe volume change ratios were 7.0% (10.6%) and 7.6% (11.1%), respectively, but showed no significant difference. Twenty of the 23 candidates were able to donate part of their liver.
CONCLUSION
Body weight reduction by exercise and diet control in potential living liver donors is effective to reduce the fatty content of the liver. Reversed percentage of the fatty content and volume of the liver was observed in these donors. The volumes of the right and left lobes of liver decreased significantly after body weight reduction. The volume changes were proportional.
引言
本研究的目的是评估潜在活体肝供体体重减轻后肝脏脂肪含量以及肝脏和脾脏体积的变化。
材料与方法
23名潜在活体供体在移植前超声检查和计算机断层扫描（CT）显示有脂肪肝。所有供体均被建议通过运动和饮食控制减轻体重。22名供体在肝脏第5段进行了经皮肝穿刺活检，以评估体重减轻前后的肝脏脂肪含量。我们比较了体重减轻前后肝脏CT衰减值的变化以及肝脏左右叶和脾脏的体积变化。
结果
体重减轻前，肝活检标本的平均（标准差）体重、体重指数和脂肪含量分别为73（17）kg、26.8（4.4）和16.9%（12.7%），之后分别为70（15）kg、25.3（3.8）和6.6%（3.7%）。这些变化具有显著性。体重减轻前，肝脏左右叶和脾脏的CT衰减值分别为54（11）HU、51（11）HU和52（5）HU，之后分别为60（8）HU、58（6）HU和53（5）HU。无论体重减轻前后，左外叶的平均CT衰减值均大于右叶。之后，肝脏左右叶和脾脏的体积分别从497（129）cm³变为452（99）cm³、927（237）cm³变为846（173）cm³和185（65）cm³变为186（63）cm³。右叶和左叶的体积变化率分别为7.0%（10.6%）和7.6%（11.1%），但无显著差异。23名候选供体中有20名能够捐献部分肝脏。
结论
潜在活体肝供体通过运动和饮食控制减轻体重可有效降低肝脏脂肪含量。在这些供体中观察到肝脏脂肪含量和体积的逆转百分比。体重减轻后肝脏左右叶体积显著减小。体积变化成比例。
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