摘要
目的总结肝脏经动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)后缺血性胆管损伤发病机制的研究进展。方法查阅近年来有关缺血性胆管损伤和肝脏TACE术后缺血性胆管损伤的发生率、病理特点及其相关机制的文献并进行综述。结果肝脏TACE术后缺血性胆管损伤的发生率波动较大,并且与不同的化疗栓塞方式相关,目前将其发生的因素归咎于栓塞引起的胆管缺血及化疗药物的毒性作用。胆管上皮保护机制被破坏和转化生长因子-β的表达在缺血性胆管损伤中可能发挥了重要作用。结论肝脏TACE术后,除缺血及化疗药物的毒性作用造成胆管的直接损伤以外,进一步由缺血和化疗药物对胆管上皮保护机制的破坏使得胆汁酸的毒性作用得以发挥也可能在缺血性胆管损伤中扮演了非常重要的角色。但目前仍然缺乏胆管上皮保护机制在肝脏TACE术后缺血性胆管损伤中的直接证据,进一步明确胆管上皮保护机制在肝脏TACE术后缺血性胆管损伤中的作用有助于探索其防治措施并为今后的研究提供思路。
Objective To summarize the research progress on the pathogenesis of ischemic bile duct injury after transcatheter arterial chemoembolization(TACE).Method The recent studies on the incidence,pathological features and related mechanisms of ischemic bile duct injury and ischemic bile duct injury after TACE were reviewed.Results The incidence of ischemic bile duct injury after liver TACE fluctuated greatly and was related to different chemoembolization methods.At present,the causes of ischemic bile duct injury were attributed to the bile duct ischemia caused by embolization and the toxic effects of chemotherapeutic drugs.The destruction of protective mechanism of bile duct epithelium and the expression of transforming growth factor-βmight play an important role in ischemic bile duct injury.Conclusions After liver TACE,in addition to the direct injury of bile duct caused by the toxic effects of ischemia and chemotherapy drugs,the damage of bile duct epithelial protection mechanism caused by ischemia and chemotherapy drugs makes the toxic effects of bile acids play a very important role in the ischemic bile duct injury.However,there is still no direct evidence of bile duct epithelial protection mechanism in ischemic bile duct injury after liver TACE.Further clarifying the role of bile duct epithelial protection mechanism in ischemic bile duct injury after liver TACE will be helpful to explore its prevention and treatment measures,and provide new insights for the further studies in future.
作者
舒鹏
程龙
谢川
代鑫
王强
汪涛
SHU Peng;CHENG Long;XIE Chuan;DAI Xin;WANG Qiang;WANG Tao(Department of General Surgery,General Hospital of Western Theater Command,Chengdu 610083,P.R.China;Department of Hepatobiliary Surgery,School of Clinical Medicine,Southwest Medical University,Luzhou,Sichuan 646000,P.R.China;Department of Hepatobiliary Surgery,School of Clinical Medicine,North Sichuan Medical College,Nanchong,Sichuan 637000,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第10期1378-1383,共6页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省青年科技基金项目(项目编号:2016JQ0023)。
关键词
缺血性胆管损伤
经动脉化疗栓塞术
病理机制
研究进展
ischemic bile duct injury
transcatheter arterial chemoembolization
pathological mechanism
research progress
