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目的:比较经门静脉及肝动脉两种途径肝内植入海藻酸钠微囊对肝纤维化影响的差别,探求一种更安全、更简便的胰岛植入途径。方法:实验犬30只随机分为A、V2组,每组15只,分别作为经肝动脉植入组及经门静脉植入组,A、V两组各随机分为3个小组,每小组5只,分别植入海藻酸钠微囊8000个/kg、16000个/kg、32000个/kg,观察植入前后血清肝纤维化标志物Ⅳ型胶原(CIV)的变化,并对肝脏进行病理组织学检查。结果:血清纤维化指标:V组:血清CIV值在植入后逐渐升高,植入前后有明显差别(P<0.01);且各植入量组间存在显著性差异(P<0.01)。A组:血清CIV值在植入后轻度升高,但植入前后无显著差异(P>0.05),且各植入量组间的差异无统计学意义(P>0.05)。相同植入量Vn及An组间血清CIV值的比较差异有显著性(P<0.01)。肝脏病理组织学检查:植入术后12周时,V3组肝脏组织学检查发现汇管区少量胶原纤维沉积,肝细胞浊肿,间质见炎性细胞浸润;而A组肝脏组织学检查未见明显异常。结论:植入量达到32000个/Kg时,经门静脉植入可造成中远期肝损伤,导致肝纤维化;而经肝动脉植入对肝脏损伤小,将有望成为一种相对简单、安全的植入途径。
OBJECTIVE: To compare the difference of hepatic fibrosis induced by intra-hepatic implantation of sodium alginate microcapsules via portal vein and hepatic artery, and to find a safer and easier way to implant pancreatic islets. Methods: 30 dogs were randomly divided into A and V2 groups, 15 rats in each group, which were implanted as hepatic artery and portal vein respectively. A and V groups were randomly divided into three groups of 5 Only the sodium alginate microcapsules were implanted at 8000 / kg, 16000 / kg and 32000 / kg, respectively. The changes of serum markers of type Ⅳ collagen (CIV) before and after implantation were observed, and the pathological tissues of the liver School inspection. Results: Serum fibrosis index: Group V: The serum CIV value increased gradually after implantation, and there was a significant difference between before and after implantation (P <0.01). There was significant difference between each implantation group (P <0.01). In group A, the serum CIV value increased slightly after implantation, but there was no significant difference between before and after implantation (P> 0.05). There was no significant difference between the three groups (P> 0.05). The same amount of implantation Vn and An group serum CIV value difference was significant (P <0.01). Histopathological examination of liver: At week 12 after implantation, a small amount of collagenous fiber deposition, hepatocytic turbidity and mesenchymal inflammatory cell infiltration were found in the liver of group V3, while no histological examination of liver in group A Obvious abnormalities. Conclusions: Implantation at the portal vein can cause liver damage in the middle and long term, resulting in hepatic fibrosis when implanted at 32,000 cells / Kg. However, the hepatic fibrosis induced by hepatic artery implantation is expected to be a relatively simple and safe Implantation.