Hickman R, Oakland C, Innes C R, McLeod H, Terblanche J
Department of Surgery and Medical Research Council Liver Research Centre, University of Cape Town, South Africa.
J Hepatol. 1988 Apr;6(2):193-200. doi: 10.1016/s0168-8278(88)80031-x.
This study describes the effects upon various functions of the porcine liver, especially the energy charge, after ligation of the hepatic artery or diversion of portal venous blood either with or without revascularisation by arterial or vena caval blood. Energy charge was significantly reduced for up to 2 days after arterial ligation but by 7 days was showing a return towards normal. Levels of adenosine triphosphate were affected most. The ketone body ratio was well maintained. A sharp elevation in levels of aspartate aminotransferase was noted at 2 days but had returned towards normal by 7 days while the prothrombin index and plasma fibrinogen tended to fall. There were inconsistent changes after portal diversion. These data indicate that the hepatic arterial, rather than portal venous inflow is important in the maintenance of porcine hepatic energy charge. This fact has physiological implications, and there is also an important application in the field of liver transplantation, where it may be that the ischaemic liver should be rearterialised first rather than after revascularisation with portal venous blood.
本研究描述了在结扎肝动脉或改变门静脉血流(无论有无通过动脉血或腔静脉血进行血管重建)后,对猪肝各种功能的影响,尤其是对能量代谢的影响。肝动脉结扎后长达2天,能量代谢显著降低,但到第7天显示出恢复正常的趋势。三磷酸腺苷水平受影响最大。酮体比率保持良好。天冬氨酸转氨酶水平在第2天急剧升高,但到第7天已恢复正常,而凝血酶原指数和血浆纤维蛋白原则趋于下降。门静脉血流改变后变化不一致。这些数据表明,肝动脉血流而非门静脉血流对维持猪肝的能量代谢很重要。这一事实具有生理学意义,在肝移植领域也有重要应用,即缺血肝脏可能应首先进行动脉再通,而非在门静脉血流重建之后。