Wang X, Andersson R, Ding J, Norgren L, Bengmark S
Department of Surgery, Lund University, Sweden.
HPB Surg. 1993;6(3):151-62. doi: 10.1155/1993/27630.
Sepsis and bacterial infections are frequent complications of acute liver failure and following major liver resection. The mechanisms underlying this phenomenon are unclear. In this study, RES function and blood clearance of radiolabelled E. coli was immediately impaired following 90% hepatectomy, although the reduction in liver volume resulted in an increase in splenic (temporary) and pulmonary (persisting) uptake. A significant correlation between liver function and host RES function was observed. The uptake capacity of the RES in the liver remnant and spleen did not correlate with subserosal blood flow. The uptake in the brain gradually increased with time, paralleling an increased leakage across the blood-brain barrier. Thus, a significantly impaired RES function resulted from experimental 90% hepatectomy-induced acute liver failure, which might explain the high incidence of septic events in the clinical situation.
脓毒症和细菌感染是急性肝衰竭及大肝切除术后常见的并发症。这一现象背后的机制尚不清楚。在本研究中，90%肝切除术后，放射性标记大肠杆菌的RES功能和血液清除立即受损，尽管肝脏体积减小导致脾脏（暂时）和肺部（持续）摄取增加。观察到肝功能与宿主RES功能之间存在显著相关性。肝残余和脾脏中RES的摄取能力与浆膜下血流无关。大脑中的摄取随时间逐渐增加，与血脑屏障渗漏增加平行。因此，实验性90%肝切除诱导的急性肝衰竭导致RES功能显著受损，这可能解释了临床情况下脓毒症事件的高发生率。
