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

肝切除术前肝功能新评价：线粒体、微粒体、网状内皮系统功能全面评价。

• 批准号: 03670633
• 负责人: CHIJIIWA Kazuo
• 金额: $ 1.34万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1992
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-03670633/
• 关键词: Hepatectomy; Liver cirrhosis; Liver regeneration; Arterial ketone body ratio-hydroxycholesterol; Mitochondria; 7エア; Microsome; Fibronectin; Reticuloendothelial system; 7αーhydroxycholesterol

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

为评价肝切除术前后反映肝功能的临床指标，我们同时测定了肝切除术前、后动脉血中反映线粒体、微粒体和网状内皮系统功能的三项指标：动脉酮体比率（AKBR）、7 α-羟基胆固醇（7 α-hydroxycholesterol）和纤维连接蛋白（fibronectin）。硫代乙酰胺（TAA）诱导的大鼠肝切除后第1、2、3天，与正常大鼠比较，肝切除后第1、2、3天的再生率无显著性差异，第2、3天的再生率与正常大鼠比较无显著性差异，第3天的再生率与正常大鼠比较无显著性差异。肝切除前两组大鼠AKBR无明显差异，肝切除后第1天两组大鼠AKBR均下降，第2天恢复正常，肝切除后第7天TAA大鼠AKBR明显低于正常大鼠，提示AKBR降低与肝硬化后再生不良有关。 ...更多信息 肝切除术前、后，TAA大鼠的7 α-羟基胆固醇（7 α-hydroxycholesterol，E1）均高于正常大鼠，两组大鼠肝切除术后第1天7 α-hydroxycholesterol均下降，第3天恢复至术前水平，术后第7天正常大鼠7 α-hydroxycholesterol明显高于术前水平，而TAA大鼠7 α-hydroxycholesterol无明显差异。肝微粒体酶活性的升高可能与肝再生有关，肝切除术前后TAA大鼠肝微粒体纤维连接蛋白水平低于正常大鼠，肝切除术后肝微粒体纤维连接蛋白水平升高。结果表明，两组患者的上述三项指标均在第3天恢复正常，第7天恢复正常，这一变化可能先于网状内皮细胞活化，但与再生率无关切除两段以上肝的病人所有患者肝切除前AKBR均正常（>1.0），手术当天下降，术后第3天恢复。但其中一名患者后来未能出现肝衰竭，这表明AKBR的短暂升高不足以恢复。7 α-羟基胆固醇和纤连蛋白水平差异很大，这些变化主要是由于输血造成的，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