摘要
正常肝再生能力强大，而肝硬化肝再生能力低下，肝功能储备不足，致使肝切除术后肝衰竭发生率大大增加，限制了大范围肝切除术的开展。肝硬化肝细胞虽具有再生能力，但受到抑制，其再生的肝细胞形态结构及生理功能均不完整，而ECM沉积、肝窦毛细血管化等病理生理学改变，及肝细胞能量代谢失衡、肝窦内皮细胞分泌异常等是导致其再生能力受损的重要机制。多种因素可刺激肝硬化肝再生，包括RFA、部分肝切除术、门静脉栓塞术和结扎术、联合肝脏分隔和门静脉结扎的二步肝切除术、脾切除术、药物、细胞移植和细胞因子等。合理联合多种手段促进肝硬化肝再生，对提高肝切除术的安全性及治疗终末期肝病均具有重要意义。
Compared with the regeneration ability of normal liver, that of liver with cirrhosis is so weak that its reserve function is insufficient, resuhing in a great increase of chance of liver failure after partial hepatectomy, and limiting the development of major hepatectomy. It has been demonstrated that the hepatocytes of cirrhosis still possess the suppressed ability of regeneration. The morphological structures as well as physiological functions of regenerated hepatocytes are not complete. The important mechanisms leading to the impairment of regeneration ability include pathophysiologic changes such as excessive deposition of extracellular matrix and the capillarization, the imbalance of energy metabolism of hepatocytes and disruptive secretion of sinus endothelial cells and so on. The clinical observation is that many factors can stimulate the regeneration of liver with cirrhosis, including radiofrequency ablation, partial hepatectomy, associated liver partition and portal vein ligation for staged hepa- tectomy, splenectomy, drugs, cell transplantation, tokines et al. It is of great significance to promote the regeneration ability of liver with cirrhosis associated with various approaches reasonably for enhancing the security of partial hepatectomy and treatment of end-stage liver diseases.
作者
吴心强
陈亚进
Wu Xinqiang Chen Yajin(Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2017年第2期210-214,共5页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金面上项目（81372562）
关键词
肝肿瘤
肝硬化
肝再生
肝切除术
Liver neoplasms
Liver cirrhosis
Liver regeneration
Hepatectomy
