| Objective:To explore the protection and possible mechanism of Terlipressin on the rat's remnant livers after major hepatectomy by establishing a rat model of small-for-size liver.Method : Establish a rat model of small-for-size syndrome with 70 percent hepatectomy and PTC( portal triad clamping) for 30 minutes refer to the Higgins methed。Rats were divided into two groups:Terlipressin group and Control group.When the rats being Executed at different timepoints after portal vein reperfusion,the serum liver function (ALT,AST,TBil)were measured,the liver tissues were harvested and studied with pathological observation and the expressions of A20,iNOS,ET-1 were detected by immunohistochemictry methods.Some rats for monitoring the portal vein pressure before administratoring Terlipressin and the 0.5 hour,1 hour,and 2 hours timepoints after reperfusion,also some rats for monitoring the 7-day survival rates of the two groups.Results: The levels of liver function were significantly decreased in the Terlipressin group when compared with the Control group At 6 hours (ALT:605.82±3.58 vs 709.94±2.98;AST:905.52±3.37 VS 1159.94±3.76;TBil: 4.12±0.23 vs 5.27±0.26) and 24 hours (ALT : 711.36±3.11 vs 854.65±3.24 ; AST: 1042.36±3.51 VS 129.68±3.46;TBil: 5.86±0.21 vs 7.18±0.25) timepoints(P<0.05),though both of them increased saliently.Microscopic observation showed that the morphological changes of remnant liver in Terlipressin group at every timepoint were markedly milder than that in Control group.Immunohistochemical staining showed that A20 expression were stronger at Terlipressin group compared to Control group at 2 hours,4 hours,6 hours timepoints except of hardly expression at 0.5 hour timepoint in the two group,and there was no marked difference of A20 expression at 24 hours after reperfusion.ET-1 were overexpressed in both groups from the 0.5 hour timepoint, it was markedly down-regulated in Terlipressin group at 24 hours timepoint compared to the Control one。From 0.5 hour timepoint, iNOS was feeble expressed in each group,and it was markedly up-regulated compared to Terlipressin group at other timepoints.The obvious discrepancy showed at the 2 hours timepoint between the two groups.The portal vein pressure of Terlipressin group were significantly lower than that of homologous Control group at different timepoints.Especilly at the 0.5 hour and 1 hour timepoints after portal vein reperfusion( P<0.05),but the elementary portal vein pressures in the two groups haven't conspicuous discrepancy(10.11±1.32 vs 9.98±1.33) ( P>0.05).The survival rate of Terlipressin group was higher obviously than the Control one(100% vs 58.3%)( P<0.05).Conclusion: Model with 70 percent hepatectomy and PTC( portal triad clamping) for 30 minutes was so stable and fit for the study of small-for-size syndrome .Terlipressin can lower the early portal vein pressure effectively after major hepatectomy , can ameliorate the early inflammatory response of the small-for-size liver after reperfusion,can attenuate the mechanical injury of sinu hepaticus,can sustain a stable microcirculation of the remnant liver,also it can palliate hepatocellular necrosis or apoptosis,then protects the function of the remnant liver and raises the survival rate. |
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