探讨大范围肝组织淤血对大鼠肝切除术后早期残肝功能及肝再生能力的影响。

健康雄性SD大鼠50只，按随机数字表法随机分为淤血组和非淤血组，每组25只。淤血组行肝中叶+左叶切除+尾状叶静脉结扎，非淤血组行肝中叶+左叶切除。检测术后24 h的ALT、AST、TB、血氨。Western blot检测肝组织cleaved caspase-3和增殖细胞核抗原（PCNA）蛋白表达。观察两组术后生存情况，检测指标比较采用t检验，生存分析采用Kaplan-Meier法和Log-rank检验。

术后24 h，淤血组的ALT、AST、TB、血氨分别为（638±34）U/L、（675±26）U/L、（1.94±0.07）μmol/L、（250±23）μmol/L，明显高于非淤血组的（362±28）U/L、（412±20）U/L、（1.47±0.11）μmol/L、（131±19）μmol/L（t=14.09，17.88，8.05，8.82；P<0.05）；淤血组肝组织出现明显肝细胞空泡变性。淤血组肝组织cleaved caspase-3蛋白表达量为1.52±0.15，明显高于非淤血组的1.09±0.12，PCNA蛋白表达量为0.63±0.14，明显低于非淤血组的1.13±0.15（t=5.06，-5.55；P<0.05）。淤血组生存率为20%，明显低于非淤血组的75%（χ²=18.21，P<0.05）。

大范围的肝组织淤血可促进大鼠肝切除术后肝组织细胞凋亡，降低肝再生能力，同时加重早期残肝功能的损害。

To investigate the effects of extensive liver congestion on the remnant liver function and liver regeneration in the early stage after hepatectomy in rats.

According to the random number table method, 50 healthy, male SD rats were randomly divided into the congestion and non-congestion groups with 25 rats in each group. In the congestion group, middle and left lobectomy of liver + caudate lobe venous ligation was performed. In the non-congestion group, middle and left lobectomy of liver was performed. The levels of ALT, AST, TB and plasma ammonia were detected at 24 h after operation. The expression levels of cleaved caspase-3 and proliferating cell nuclear antigen (PCNA) proteins in liver tissues were detected by Western blot. Postoperative survival situation of two groups was observed, the detection indexes were compared using t test, and the survival analysis was performed by Kaplan-Meier method and Log-rank test.

At 24 h after operation, the levels of ALT, AST, TB and plasma ammonia in the congestion group was respectively (638±34) U/L, (675±26) U/L, (1.94±0.07) μmol/L and (250±23) μmol/L, significantly higher than (362±28) U/L, (412±20) U/L, (1.47±0.11) μmol/L and (131±19) μmol/L in the non-congestion group (t=14.09, 17.88, 8.05, 8.82; P<0.05). Evident vacuolar degeneration of liver cells was observed in the congestion group. The expression of cleaved caspase-3 protein in the liver tissue of the congestion group was 1.52±0.15, significantly higher than 1.09±0.12 of the non-congestion group (t=5.06, P<0.05). The expression of PCNA protein in the liver tissue of the congestion group was 0.63±0.14, significantly lower than 1.13±0.15 of the non-congestion group (t=-5.55, P<0.05). The survival rate in the congestion group was 20%, significantly lower than 75% in the non-congestion group (χ²=18.21, P<0.05).

Extensive liver congestion can promote liver cell apoptosis, reduce liver regeneration and aggravate the damage of remnant liver function in early stage after hepatectomy in rats.