• 作者： 陳敏夫; 黃燦龍
• 作者服務機構： 長庚紀念醫院一般外科
• 中文摘要： 動物實驗及人體實際經驗，已經證實正常肝經部份切除以後會再生，包括體積及功能之恢復。以大白鼠為例，經2/3肝切除以後，其DNA即於術後22-28小時達於最高，以後其分化即趨於緩和，約7天以後，可以恢復至原來體積之大小；但有關硬化肝切除以後之再生，仍有爭議。本研究是以動物實驗模式之硬化肝，施予部份切除後，肝再生之探討。硬化肝之造成，是依據1982年Proctor及Chatamra之報告，使用CC1/phenobarbital誘發180-220gn之大白鼠，產生肝硬化。依Higgins與Anderson之方法，施以33%及70%之肝切除；於術後第一、二、三及七天計算殘餘肝體積之恢復比率及肝細胞DNA之合成能力為指標，研究硬化肝之再生。 結果，造成大白鼠肝硬化之成功率約為75歸，實驗過程中，有25%之死亡率。另外，70％肝切除組，亦有33%之死亡率。初步結論，殘餘肝於術後不同時間，體積之恢復比率與DNA合成能力，皆顯示大白鼠之硬化肝經部份切除後，具有某種程度之再生；與正常肝比較，其再生能力顯然有差異。以後之研究方向，應朝向促進肝再生因子，如肝生長素及基因之研究，探討正常肝與硬化肝再生之不同。
• 英文摘要： There are conflicting data regarding the ability of the liver to regenerate after partial hepatectomyin animals and humans with cirrhosis. The purpose of this study was to document liver regeneration afterpartial hepatectomy in a carbon tetrachloride rat model of cirrhosis. Liver cirrhosis was produced byweekly intragastric gavage with carbon tetrachloride in 80 adult male rats. Vehicle-gavaged rats (n＝24)served as healthy controls. Liver regeneration was documented 1,2,3 and 7 days after partial hepatectomyon the basis of restitution of liver mass and [H] thymidine incorporation into liver DNA. Restitution ofliver mass after partial hepatectomy was significantly decreased in carbon tetrachloride-treated rats at 1and 7 days compared with the vehicle-treated control rats. In cirrhotic rats, restitution of liver mass at1,2,3 and 7 days did not differ between 33% and 70% hepatectomy. Hepatic DNA synthesis, however,was significantly impaired at 1 and 2 days in cirrhotic rats after 70% hepatectomy and also at 1 day after33% hepatectomy compared with non-cirrhotic rats. The results of this study indicated that live regenerationdid occur after partial hepatectomy in carbon tetrachloride-treated rats but was impaired in comparisonwith that in vehicle-treated control rats.
• 中文關鍵字： liver regeneration; liver cirrhosis; partial hepatectomy; carbon tetrachloride/phenobarbital.
• 英文關鍵字： --