Department of Surgery, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
Biomed Res Int. 2013;2013:192029. doi: 10.1155/2013/192029. Epub 2013 Aug 24.
The impact of hepatic steatosis on outcome following hepatic ischemia-reperfusion injury (IRI) remains controversial with conflicting clinical results. A number of experimental studies have been published examining the relationship between hepatic steatosis and IRI. This systematic review evaluates these experimental studies.
An electronic search of the Medline and Embase databases (January 1946 to June 2012) was performed to identify studies that reported relevant outcomes in animal models of hepatic steatosis subjected to IRI.
A total of 1314 articles were identified, of which 33 met the predefined criteria and were included in the study. There was large variation in the type of animal model, duration, and type of IRI and reporting of histological findings. Increased macrovesicular steatosis (>30%) was associated with increased histological damage, liver function derangement, and reduced survival. Increased duration of warm or cold ischemia had a negative impact on all outcomes measured. Microvesicular steatosis did not influence outcome.
Findings from this systemic review support the hypothesis that livers with >30% macrovesicular steatosis are less tolerant of IRI. Clinically, it is likely that these findings are applicable to patients undergoing hepatic resection, but further studies are required to confirm these data.
肝脂肪变性对肝缺血再灌注损伤（IRI）后结局的影响仍存在争议，临床结果相互矛盾。已经发表了许多研究实验来检验肝脂肪变性与 IRI 之间的关系。本系统评价评估了这些实验研究。
通过电子检索 Medline 和 Embase 数据库（1946 年 1 月至 2012 年 6 月），以确定报道了接受 IRI 的肝脂肪变性动物模型相关结局的研究。
共确定了 1314 篇文章，其中 33 篇符合预设标准并纳入研究。动物模型的类型、IRI 的持续时间和类型以及组织学发现的报告存在很大差异。大泡性脂肪变性（>30%）增加与组织学损伤、肝功能障碍和存活率降低有关。热缺血或冷缺血时间延长对所有测量的结局均有负面影响。微泡性脂肪变性不影响结局。
本系统评价的结果支持以下假说，即>30%大泡性脂肪变性的肝脏对 IRI 的耐受性较差。临床上，这些发现可能适用于接受肝切除术的患者，但需要进一步的研究来证实这些数据。
