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The influence of the splenic venous flow on the liver fibrosis and regeneration.

脾静脉血流对肝纤维化和再生的影响。

基本信息

批准号：
16591363
负责人：
YOSHIDA Hiroshi
金额：
$ 2.18万
依托单位：
Nippon Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-16591363/
关键词：
hemodynamics liver fibrosis liver regeneration gene spleen

项目摘要

Objectives : The aim of this study is to prove the hemodynamic change in distribution of splenic venous flow in the liver, especially in the cirrhotic liver, and to reveal and evaluate a participation of splenic venous flow in regeneration or enlargement of the hepatic lobe.Methods : We studied the distribution of splenic venous flow in the liver of patients with normal liver (NL group, n=14), chronic hepatitis (CH group, n=11), and liver cirrhosis (LC group, n=13) with the technique of scintiphotosplenoportography after percutaneous intrasplenic injection of Technetium-99m-diethylenetriaminepentaacetic asid-galactosyl-human serum albumin. The index of splenic venous flow volume per unit hepatocytes (V_<unit>) was calculated in each hepatic lobe. To compare V value of the left lobe (N Link) with that of the right lobe (V R_<unit>), predominant index of the left lobe (L/R index) was defined as L R index = V L_<unit>/ V R_<unit>.Results : The median (interquartile range) of LI R index of LC group; 1.22 (1.06・1.70) was significantly higher than that of NL group; 0.83 (0.66-0.92), p<0.001 and CH group; 0.79 (0.69-0.92), p<0.001.Conclusions : L/R index reflects the change of portal hemodynamics in cirrhotic liver and is useful for discrimination between noncirrhosis and cirrhosis. These results suggest that in the liver exposed to continuous damages, splenic venous blood promotes liver fibrosis in the right lobe and eventually flows more into the left lobe with milder fibrosis.

目的：本研究的目的是证实脾静脉血流在肝脏，特别是在肝硬化时分布的血流动力学变化，揭示和评价脾静脉血流在肝叶再生或扩大中的作用。我们研究了正常肝脏患者脾静脉血流在肝脏中的分布经皮脾内注射99 mTc-二乙烯三胺五乙酸-半乳糖基-人血清白蛋白后行脾门静脉造影，对正常对照组（NL组，n=14）、慢性肝炎组（CH组，n=11）和肝硬化组（LC组，n=13）进行观察。计算各肝叶单位肝细胞脾静脉血流量指数（V_<unit>）。比较左、右叶的V值（N Link）<unit>，定义左叶优势指数（L/R指数）= V L<unit>/ V R<unit>。中位数LC组LI R指数（四分位距）为1.22（1.06·1.70）显著高于NL组（0.83（0.66-0.92），p<0.001，CH组; 0.79（0.69-0.92），p<0.001。结论：L/R指数反映了门脉血流动力学的变化，对鉴别肝硬化与非肝硬化有一定的参考价值。这些结果表明，在暴露于连续损伤的肝脏中，脾静脉血促进右叶的肝纤维化，并最终更多地流入左叶，纤维化程度较轻。