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目的:观察急性肝损伤、暴发性肝衰竭时肝再生的变化及血浆内毒素变化对暴发性肝衰竭肝再生的影响。方法:硫代乙酰胺复制动物模型,鲎试剂法测定血浆内毒素含量,流式细胞仪及增殖细胞核抗原免疫组化测定细胞增殖情况。结果:暴发性肝衰竭增殖细胞核抗原标志指数及肝细胞增殖指数较急性肝损伤明显增高(P 值<0.05);暴发性肝衰竭早期血浆内毒素与细胞增殖指数呈正相关(r=0.8745 P 值<0.01),但暴发性肝衰竭晚期血浆内毒素与细胞增殖指数呈负相关(r=-0.7776 P 值<0.01),而此时血浆内毒素与血浆转氨酶(AST)呈正相关(r=0.7391 P 值<0.05)。结论:暴发性肝衰竭动物有较强的再生能力,肠源性内毒素血症与暴发性肝衰竭肝损伤及肝再生密切相关。
Objective: To observe the changes of liver regeneration in acute liver injury and fulminant hepatic failure and the effect of plasma endotoxin on the liver regeneration in fulminant hepatic failure. Methods: The animal model of thioacetamide was replicated. The plasma endotoxin level was determined by 鲎 reagent method. The proliferation of cells was detected by flow cytometry and proliferating cell nuclear antigen immunohistochemistry. Results: The index of proliferating cell nuclear antigen and hepatocyte proliferation index in fulminant hepatic failure were significantly higher than those in acute hepatic injury (P <0.05). The plasma endotoxin in early stage of fulminant hepatic failure was positively correlated with cell proliferation index (r = 0.8745 P < 0.01). However, there was a negative correlation between plasma endotoxin and cell proliferation index (r = -0.7776 P <0.01) in patients with fulminant hepatic failure, and there was a positive correlation between plasma endotoxin and plasma AST (r = 0.7391 P <0.05). Conclusion: The animals with fulminant hepatic failure have strong regenerative capacity. Intestinal endotoxemia is closely related to hepatic injury and liver regeneration in fulminant hepatic failure.