New evaluation of hepatic function before and hepatectomy:Total evaluation of the functions mitochodria,microsome and reticuloendothelial system.

为了评价肝切除术前后反映肝功能的临床指标，我们同时测定了反映线粒体、微粒体和网状内皮系统功能的动脉酮体比（AKBR）、7 α -羟胆固醇和纤维连接蛋白的变化。取70%肝切除术前、术后1天、2.3天、7天的肝硬化大鼠和正常大鼠的动脉血。称重计算肝脏再生率。TAA大鼠第1、2、3天的再生率两组间无显著差异，但第7天的再生率明显低于正常大鼠。肝切除术前两组间AKBR无差异。两组患者AKBR均在术后第1天下降，第2天恢复。肝切除术后第7天，TAA大鼠的AKBR明显低于正常大鼠，提示AKBR降低与肝硬化肝脏再生不良有关。肝切除术前后TAA大鼠7 -羟胆固醇水平明显高于正常大鼠。两组患者术后第1天7 α -羟胆固醇均下降，术后第3天恢复至术前水平。肝切除术后第7天，正常大鼠7 α -羟胆固醇明显高于术前水平，而TAA大鼠无差异。微粒体酶活性的升高可能与肝脏再生有关。TAA大鼠肝切除术前后纤维连接蛋白水平均低于正常大鼠。肝切除术后1 ~ 3天纤维连接蛋白升高，第7天恢复正常。这些变化可能先于网状内皮细胞活化，但与再生速率无关。我们还测定了肝切除超过2节段的患者的这三个参数水平。所有患者在肝切除术前AKBR均为正常（bbb1.0），手术当日AKBR下降，术后第3天恢复。然而，其中一名患者后来没有肝衰竭，表明短暂的AKBR升高不足以恢复。7 -羟胆固醇和纤维连接蛋白的水平变化很大。这些变化主要是由于输血，因此这些水平不太可能反映微粒体和网状内皮系统的确切功能。少

To evaluate the clnical index reflecting liver function before and after hepatectomy,we simultaneously determined changes in arterial ketone body ratio(AKBR),7alpha-hydroxycholesterol and fibronectin,which are known to reflect the function of mitochondria,microsome and reticuloendothelial system,respectively.Arterial blood was obtained before and on 1,2.3 and 7 days after 70% hepatectomy in thioacetamide(TAA)-induced cirrhotic and normal rats.The liver was weighed to calculate regeneration rate.The regeneration rate on 1,2 and 3 days was not different between two groups,but on the 7th day was significantly lower in TAA rats than normal rats.AKBR did not differ between two groups before hepatectomy.AKBR decreased on the 1st day and recovered on the 2nd day after hepatectomy in both groups.On the 7th day after hepatectomy AKBR was significantly lower in TAA rats than normal rats,suggesting that lower AKBR related with poor regeneration in cirrhotic liver.The 7alpha-hydroxycholesterol lev … More el was higher in TAA rats than normal rats before and after hepatectomy.In both groups 7alpha-hydroxycholesterol was decreased on the 1st day but recovered to the preoperative level on the 3rd day after hepatectomy.On the 7th day after hepatectomy 7alpha-hydroxycholesterol was significantly higher than the preoperative level in normal rats,whereas it was not different in TAA rats. The elevation of microsomal enzyme activity might be paralleled with liver regeneration.Fibronectin levels were lower before and after hepatectomy in TAA rats than normal rats.After hepatectomy fibronectin was elevated on 1-3 days and returned to normal level on the 7th day in both groups.These changes might precede reticuloendothelial activation but were not related with the regeneration rate.We also determined these three parameter levels in patients who hepatectomized more than 2-segments. In all patients,AKBR was normal (>1.0)before hepatectomy and decreased on the operation day and recovered on the 3rd day after hepatectomy. However,one of the patients failed to liver failure later,indicating that transient elevation of AKBR is not enough for the recovery.The levels of 7alpha-hydroxycholesterol and fibronectin were widely varied.These variations were mainly due to transfusion,and therefore these levels are not likely to reflect the exact functions of microsome and reticuloendothelial system. Less