Yang Xianwei, Yang Chuang, Qiu Yiwen, Shen Shu, Kong Junjie, Wang Wentao
Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Department of Hepatobiliary and Pancreatic Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan 621000, P.R. China.
Exp Ther Med. 2019 Aug;18(2):1203-1211. doi: 10.3892/etm.2019.7688. Epub 2019 Jun 18.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in a rat model of liver cirrhosis has not, to the best of our knowledge, been previously investigated. The present study therefore aimed to establish a model of ALPPS in cirrhotic rats and to assess liver regeneration. Rats were randomly divided into an ALPPS group with carbon tetrachloride-induced cirrhosis (group A) and a normal liver (group B). Rat weight, cytokine levels, biochemical parameters and histopathology were assessed 1, 2, 3, 7 and 14 days after ALPPS. Higher aspartate aminotransferase and alanine aminotransferase levels were detected in group A on the first postoperative day. On the first, second and third days, hepatocyte proliferation rate was higher in group B than in group A. After 3 days, hepatocyte proliferation rate in group B began to decrease, but the rate in group A continued to increase until the 14th day. Higher levels of hepatocyte growth factor, interleukin-6 and tumor necrosis factor-α were detected in group A compared with group B, but the differences were not significant. The present study demonstrated that ALPPS promoted liver regeneration in a rat model of cirrhosis, but significantly impaired liver function. Compared with the ALPPS model, group B exhibited a delayed peak of proliferation. The mechanism of liver regeneration induced by ALPPS in cirrhotic rats may be associated with increased cytokine levels.
据我们所知，此前尚未在肝硬化大鼠模型中研究过联合肝脏分割和门静脉结扎分期肝切除术（ALPPS）。因此，本研究旨在建立肝硬化大鼠的ALPPS模型并评估肝脏再生情况。将大鼠随机分为四氯化碳诱导肝硬化的ALPPS组（A组）和正常肝脏组（B组）。在ALPPS术后1、2、3、7和14天评估大鼠体重、细胞因子水平、生化参数和组织病理学。术后第一天，A组检测到较高的天冬氨酸转氨酶和丙氨酸转氨酶水平。在第一、第二和第三天，B组的肝细胞增殖率高于A组。3天后，B组的肝细胞增殖率开始下降，但A组的增殖率持续上升直至第14天。与B组相比，A组检测到较高水平的肝细胞生长因子、白细胞介素-6和肿瘤坏死因子-α，但差异不显著。本研究表明，ALPPS促进了肝硬化大鼠模型的肝脏再生，但显著损害了肝功能。与ALPPS模型相比，B组表现出增殖高峰延迟。ALPPS诱导肝硬化大鼠肝脏再生的机制可能与细胞因子水平升高有关。
