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门脉支结扎对门脉血供阻断和未阻断肝组织中组织再生、微循环反应和微结构的影响。

Impact of portal branch ligation on tissue regeneration, microcirculatory response and microarchitecture in portal blood-deprived and undeprived liver tissue.

机构信息

Department of General, Vascular, Thoracic and Transplantation Surgery, University of Rostock, 18057 Rostock, Germany.

出版信息

Microvasc Res. 2011 May;81(3):274-80. doi: 10.1016/j.mvr.2011.03.005. Epub 2011 Mar 21.

Abstract

Partial ligation of portal branches leads to atrophy of the deprived lobes and hypertrophy of the intact lobes. In this study we investigated the microcirculatory response and their consequences on tissue regeneration after left-sided portal branch ligation (PBL) in Sprague-Dawley rats. At day 1 and 3 after PBL the hepatic microcirculation was assessed by intravital microscopy (IVM). In addition histological, immunohistochemical and biochemical techniques were used to determine alterations of hepatic microarchitecture. IVM analysis of the microcirculation of the ligated hepatic lobes revealed significant alterations with a reduction in sinusoidal perfusion rate, a decrease of red blood cell velocity, an increase of sinusoidal diameter and a marked reduction in shear stress at days 1 and 3 after PBL. On the contrary, the non-ligated lobes presented with higher blood flow velocities, marked sinusoidal vasoconstriction and thus, shear stress elevation. In consequence, ligated liver lobes exhibited marked cell apoptosis and necrosis, being accompanied by massive intrahepatic leukocyte accumulation and a ~30% weight loss. The non-ligated liver tissue showed marked PCNA expression and thereby completely compensated weight loss. Beside full restoration of liver mass, sinusoidal blood flow was comparable in ligated and non-ligated lobes as well as in sham-treated controls. This study shows that the liver aims at constant tissue mass and blood flow, most probably for maintenance of adequate clearance function. In addition, it supports the hypothesis that shear stress plays a pivotal role in triggering liver hypertrophy in the non-ligated lobes.

摘要

部分门静脉分支结扎导致被剥夺叶的萎缩和完整叶的肥大。在这项研究中,我们研究了左侧门静脉分支结扎(PBL)后 Sprague-Dawley 大鼠肝小叶微循环反应及其对组织再生的影响。PBL 后第 1 天和第 3 天,通过活体显微镜检查(IVM)评估肝微循环。此外,还使用组织学、免疫组织化学和生化技术来确定肝微结构的变化。结扎肝叶微循环的 IVM 分析显示,在 PBL 后第 1 天和第 3 天,肝窦灌注率降低,红细胞速度下降,窦状直径增加,切应力明显降低。相反,非结扎叶表现出更高的血流速度,明显的窦状血管收缩,从而导致切应力升高。因此,结扎的肝叶表现出明显的细胞凋亡和坏死,伴随着大量的肝内白细胞积累和约 30%的体重减轻。非结扎的肝组织表现出明显的 PCNA 表达,从而完全补偿了体重减轻。除了肝脏质量的完全恢复外,结扎和非结扎叶以及假手术对照组的肝窦血流也相当。这项研究表明,肝脏的目标是恒定的组织质量和血流,这很可能是为了维持足够的清除功能。此外,它支持了切应力在触发非结扎叶肝肥大中起着关键作用的假说。

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