• 1.昆明醫(yī)學(xué)院第二附屬醫(yī)院肝膽外科（昆明650101）;;
  • 2.江西省第一人民醫(yī)院普通外科（南昌330000）;

目的探討S腺苷蛋氨酸在肝硬變大鼠行部分肝葉切除后對(duì)肝細(xì)胞的再生及肝功能的影響。方法用40%四氯化碳誘導(dǎo)Wistar大 鼠肝硬變模型，而后將成模大鼠隨機(jī)分為肝硬變組（n=20）、治療1組〔S腺苷蛋氨酸10 mg/（kg·d），n=16〕及治療2組〔S腺 苷蛋氨酸20 mg/（kg·d），n=16〕，另設(shè)正常對(duì)照組（n=16）。4組大鼠均行30%左右肝葉切除。自手術(shù)當(dāng)天起，治療1、2組分別肌 注S腺苷蛋氨酸10 mg/（kg·d）和20 mg/（kg·d），對(duì)照組肌注生理鹽水5 ml/d，共15 d。4組大鼠分別于術(shù)后15 d和30 d處死一 半，取血檢測(cè)Alb、ALT、TB、TBA及TNFα，同時(shí)在光鏡及電鏡下觀察肝組織的病理改變及超微結(jié)構(gòu)變化。結(jié)果肝硬變組術(shù)后15 d和 30 d的TB、TBA、ALT及TNFα水平明顯高于正常對(duì)照組（P＜0.01）, Alb水平明顯低于正常對(duì)照組（P＜0.01）； 治療1、2組術(shù)后 15 d的上述4項(xiàng)指標(biāo)高于正常對(duì)照組(P＜0.05)，但明顯低于肝硬變組（P＜0.01），Alb水平低于正常對(duì)照組（P＜0.05），卻明顯高 于肝硬變組（P＜0.01）； 治療1、2組術(shù)后30 d上述各指標(biāo)均接近正常對(duì)照組水平。TNFα和TB、TBA、ALT呈顯著正相關(guān)（r值分別 為 0.99、0.97、0.93， P＜0.01），與Alb呈顯著負(fù)相關(guān)（r值為-0.88，P＜0.01）。治療組光鏡觀察見肝小葉結(jié)構(gòu)基本完整，有較 多的雙核肝細(xì)胞以及少量淋巴細(xì)胞浸潤，電鏡觀察見粗面內(nèi)質(zhì)網(wǎng)及糖原增生，線粒體豐富。結(jié)論S腺苷蛋氨酸能促進(jìn)肝葉切除術(shù)后 肝細(xì)胞的再生，可改善肝功能。

引用本文： 張捷,廖傳文,朱洪,田大廣,郭永章. S-腺苷蛋氨酸在肝硬變大鼠行部分肝葉切除后對(duì)肝功能的保護(hù)作用觀察. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(4): 332-335. doi: 復(fù)制

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7. 8Lieber CS. Role of oxidative stress and antioxidant therapy in alcoholic and nonalcoholicliver diseases [Ｊ]. Adv Pharmacol， 1997; 38(8)∶601.
8. 9Drahota Z, Rauchova H, Sedlak V, et al. The effect of triiodothyronine on changes of membrane fluidity in regenerating rat liver [Ｊ]. Physiol Res， 1999; 48(2)∶167.
9. 11Watson WH,Zhao Y,Chawla RK.Sadenosylmethionine attenuates the lipopolysaccharideinduced expression of the gene for tumour necrosis alpha [Ｊ].Biochem J, 1999; 342(Pt 1)∶21.
10. 孫自勤，王要軍，權(quán)啟鎮(zhèn)，等. 肝纖維化大鼠血清有機(jī)磷酸酯酶的變化 [Ｊ].新消化病雜志， 1994; 2（4）∶206.
11. 繆明永，蔡在龍，劉鵬飛,等.大鼠在肝再生過程中線粒體氧化磷酸化的調(diào)控 [Ｊ]. 中國病理生理雜志，1999; 15(5)∶398.
  1. 1. 2Higgins GM. Experimental pathology of liver restoration of the liver of the white rat following partial surgical removal [Ｊ]. Aech Pathol, 1991; 12(2)∶186.
  2. 2. 3Almasio P, Pagliaro L. Ademetionine: the state of the art and future prospects [Ｊ]. Ann Ital Med Int， 1993; 8(1 Suppl)∶52S.
  3. 3. 4VarelaMoreiras G, AlonsoAperte E, Rubio M,et al. Carbon tetrachlorideinduced hepatic injury is associated with global DNA hypomethylation and homocysteinemia: effect of Sadenosylmethionine treatment [Ｊ]. Hepatology, 1995; 22(4 Pt 1)∶1310.
  4. 4. 5Holecek M, Skopec F, Sprongl L. Influence of buthionine sulfoximine, Sadenosylmethionine and glutathione on liver regeneration following partial hepatectomy [Ｊ]. Arzneimittelforschung， 2000; 50(12)∶1093.
  5. 5. 6Mato JM, Corrales FJ, Lu SC,et al. SAdenosylmethionine: a control switch that regulates liver function [Ｊ].FASEB J, 2002; 16(1)∶15.
  6. 6. 7Feo F,Garcea R,Daino L,et al. Early stimulation of polyamine biosynthesis during promotion by phenobartial of diethylnitrosanineinduced rat liver carcinogenesis. The effect of variations of the SadenosylLmethionine cellular pool [Ｊ].Carcinogenesis,1985; 6(12)∶1713.
  7. 7. 8Lieber CS. Role of oxidative stress and antioxidant therapy in alcoholic and nonalcoholicliver diseases [Ｊ]. Adv Pharmacol， 1997; 38(8)∶601.
  8. 8. 9Drahota Z, Rauchova H, Sedlak V, et al. The effect of triiodothyronine on changes of membrane fluidity in regenerating rat liver [Ｊ]. Physiol Res， 1999; 48(2)∶167.
  9. 9. 11Watson WH,Zhao Y,Chawla RK.Sadenosylmethionine attenuates the lipopolysaccharideinduced expression of the gene for tumour necrosis alpha [Ｊ].Biochem J, 1999; 342(Pt 1)∶21.
  10. 10. 孫自勤，王要軍，權(quán)啟鎮(zhèn)，等. 肝纖維化大鼠血清有機(jī)磷酸酯酶的變化 [Ｊ].新消化病雜志， 1994; 2（4）∶206.
  11. 11. 繆明永，蔡在龍，劉鵬飛,等.大鼠在肝再生過程中線粒體氧化磷酸化的調(diào)控 [Ｊ]. 中國病理生理雜志，1999; 15(5)∶398.