Gaudio E, Pannarale L, Onori P, Riggio O
Department of Experimental Medicine, State University of L'Aquila, Italy.
Hepatology. 1993 Mar;17(3):477-85.
Hepatic microcirculation has been related to liver function in several studies. The principle of this relationship lies in the sequential distribution of blood from the feeding vessels of the hepatic acinus to the central vein. This study was undertaken to investigate the progressive changes at different sites of the liver microvascular bed in the developing cirrhosis, both by light microscopy and scanning electron microscopy of corrosion casts. Experimental cirrhosis was induced with intragastric carbon tetrachloride. The most important vascular changes progressively observed are the reduction of the distance between the pre- and postsinusoidal vessels, the presence of newly formed shunting vessels bypassing the sinusoids and, finally, the development of a perinodular vascular plexus composed of pre- and postsinusoidal vessels. Newly formed vessels grow through preformed tissue septa. These vascular modifications make any zonal gradient hardly possible. The loss of the zonal gradient of perfusion could highly modify liver function, along with the structural changes of hepatic laminae. Hepatocyte regeneration cannot recover the original vascular relationships: this makes the morphological and functional destructuralization of cirrhotic liver irreversible.
多项研究表明肝微循环与肝功能有关。这种关系的原理在于血液从肝腺泡的供血血管依次流向中央静脉。本研究旨在通过光学显微镜和铸型扫描电子显微镜,研究肝硬化发展过程中肝脏微血管床不同部位的渐进性变化。通过胃内注射四氯化碳诱导实验性肝硬化。逐渐观察到的最重要的血管变化是窦前和窦后血管之间距离缩短、出现绕过肝血窦的新生分流血管,以及最终由窦前和窦后血管组成的结节周围血管丛的形成。新生血管通过预先形成的组织间隔生长。这些血管改变使得任何区域梯度几乎都不可能存在。灌注区域梯度的丧失可能会极大地改变肝功能,同时伴有肝板的结构变化。肝细胞再生无法恢复原来的血管关系:这使得肝硬化肝脏的形态和功能破坏不可逆。