Komura M, Chijiiwa K, Naito T, Kameoka N, Yamashita H, Yamaguchi K, Kuroki S, Tanaka M
Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
J Surg Res. 1996 Mar;61(2):503-8. doi: 10.1006/jsre.1996.0154.
To clarify the effects of obstructive jaundice on the liver, sequential changes of hepatic energy charge, the concentrations of adenine nucleotides and malondialdehyde, DNA synthesis rate, and histology of the liver were examined on the day before and Days 1, 2, 4, 7, and 14 after biliary obstruction in rats and compared with those of sham-operated controls. Foci of necrotic hepatocytes were present on Days 1 and 2 and mitoses of the hepatocytes were frequently observed with a peak on Day 2 in the jaundiced liver. Marked proliferation of bile ductules were subsequently observed on Days 7 and 14, resembling biliary cirrhosis. The DNA synthesis rate was significantly activated after bile duct obstruction with its peak on Day 2, more than nine times higher than the control value and returned to the control level on Day 14. Hepatic ATP concentration and energy charge gradually declined with prolonged jaundice and significantly lower levels persisted after Day 7 compared with the controls. The malondialdehyde level in the jaundiced liver gradually increased and became significantly higher on Day 14. We conclude that obstructive jaundice decreases hepatic energy charge and increases the lipoperoxide level. In the initial stage of obstructive jaundice, the hepatocytes proliferate associated with activated DNA synthesis probably to compensate hepatic damage; however, prolonged obstructive jaundice induces functional hepatic injury possibly necessitating biliary drainage.
为阐明梗阻性黄疸对肝脏的影响,在大鼠胆管梗阻前1天以及梗阻后第1、2、4、7和14天,检测肝脏能量负荷、腺嘌呤核苷酸和丙二醛浓度、DNA合成速率及肝脏组织学的连续变化,并与假手术对照组进行比较。在黄疸肝脏中,第1天和第2天出现坏死肝细胞灶,且频繁观察到肝细胞有丝分裂,在第2天达到峰值。随后在第7天和第14天观察到胆管显著增生,类似胆汁性肝硬化。胆管梗阻后DNA合成速率显著激活,在第2天达到峰值,比对照值高出9倍以上,并在第14天恢复到对照水平。随着黄疸持续时间延长,肝脏ATP浓度和能量负荷逐渐下降,与对照组相比,第7天后显著低于对照水平。黄疸肝脏中丙二醛水平逐渐升高,在第14天显著升高。我们得出结论,梗阻性黄疸降低肝脏能量负荷并增加脂质过氧化物水平。在梗阻性黄疸的初始阶段,肝细胞增殖并伴有DNA合成激活,可能是为了代偿肝脏损伤;然而,长期的梗阻性黄疸会导致肝脏功能性损伤,可能需要进行胆管引流。