Kameoka N, Chijiiwa K, Kozaki N, Makino I, Naito T, Tanaka M
Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Eur Surg Res. 1996;28(3):212-21. doi: 10.1159/000129459.
Selective portal vein occlusion prior to aggressive hepatic resection is now an alternative way to decrease postoperative morbidity and mortality rates. However, the detailed changes in the hepatic energy status and DNA synthesis rate in both portal vein ligated (PVL) and nonligated (PVNL) lobes of the liver are not clear. In rats, the portal branch that supplies 70% of the liver volume was ligated, and changes in arterial ketone body ratio (AKBR), liver weight, histology, DNA synthesis rate and adenine nucleotides of the PVL and PVNL liver lobes were determined before and 1, 2, 4 and 7 days after portal vein ligation, and compared with those in sham-operated rats. The weight of the PVL lobes decreased, while that of the PVNL lobes increased depending on time. The DNA synthesis rates of the PVNL lobes were significantly higher than those in sham-operated control liver during the first 4 days with the maximal value on the 2nd day, while those of PVL lobes were essentially similar to the control values. Energy charge (EC) in both PVL and PVNL lobes significantly decreased on day 1 and recovered gradually, but with less extent in the regenerating PVNL lobes. The concentrations of total adenine nucleotides (TAN) in both the PVL and PVNL lobes were essentially similar during the first 2 days, but became significantly lower in PVL lobes after day 4. A decrease in EC preceded an increase in DNA synthesis only in the PVNL lobes, in contrast to the PVL lobes. Mitosis of hepatocytes on day 2 and subsequently enlarged lobules with an increased number of hepatocytes were histologic features in the PVNL liver. The AKBR was not correlated with hepatic energy charge of the liver. In conclusion, PVNL liver regenerates preceded by a decrease in EC and a subsequent increase in DNA synthesis keeping TAN constant, while PVL liver becomes atrophic, with a similar change in EC of the PVNL liver but ultimately decreased TAN without any change in DNA synthesis. AKBR is not a parameter reflecting the hepatic EC after portal branch ligation.
在进行积极的肝切除术前进行选择性门静脉阻断，现在是降低术后发病率和死亡率的一种替代方法。然而，肝门静脉结扎（PVL）和未结扎（PVNL）肝叶中肝脏能量状态和DNA合成率的详细变化尚不清楚。在大鼠中，结扎供应70%肝脏体积的门静脉分支，并在门静脉结扎前以及结扎后1、2、4和7天测定PVL和PVNL肝叶的动脉酮体比率（AKBR）、肝脏重量、组织学、DNA合成率和腺嘌呤核苷酸，并与假手术大鼠进行比较。PVL肝叶的重量下降，而PVNL肝叶的重量随时间增加。在最初4天内，PVNL肝叶的DNA合成率显著高于假手术对照肝脏，在第2天达到最大值，而PVL肝叶的DNA合成率基本与对照值相似。PVL和PVNL肝叶的能荷（EC）在第1天显著下降，并逐渐恢复，但再生的PVNL肝叶恢复程度较小。PVL和PVNL肝叶中总腺嘌呤核苷酸（TAN）的浓度在最初2天基本相似，但在第4天后PVL肝叶中的浓度显著降低。与PVL肝叶相反，仅在PVNL肝叶中，EC的下降先于DNA合成的增加。第2天肝细胞的有丝分裂以及随后小叶增大、肝细胞数量增加是PVNL肝脏的组织学特征。AKBR与肝脏的肝能量荷不相关。总之，PVNL肝脏在EC下降随后DNA合成增加且TAN保持恒定的情况下再生，而PVL肝脏萎缩，PVNL肝脏的EC有类似变化，但最终TAN降低且DNA合成无任何变化。AKBR不是反映门静脉分支结扎后肝脏EC的参数。
