The Analysis Of The Reported Cases Of Hepatic Veno-occlusive Disease And Related Basic Researches

Purpose:To investigate the clininal characters and diagnosis and treatment of hepatic veno-occlusive disease(HVOD),then to detect the hepatotoxic pyrrolizidine alkaloids (HPA) in the Sedum aizoon and investigate the establishment of the hepatic veno-occlusive model in miceMethods:The clinical data of nineteen patients reported in home with HVOD were analyzed retrospectively;Comparative study was applied to study the prognosis,symptoms and signs,laboratory finding(special Examinations),differential diagnosis,complications and effective treatment of VOD,which reported in domestic and overseas.The alkaloid extracts of Sedum aizoon root were detected and analyzed by the method of combination of TLC, and GC/MS. Sixty KunMing mice were randomly divided into experimental group and control group equally.The experimental group was raised by the total alkaloid with sublethal dose(50mg/kg qod) ,while the control group was raised by Cyclophosphamide (30mg/d qod) for 4 weeks.Every day the weights of mice were written down and symptoms and signs were observed.When ascites was found ,the mice were killed to be take pathological examination. Results and Conclusions:Nine patients with specific pathogeny had taken Chinese herbs,including Sedum aizoon and Herba Senecionis Scandentis. Hepatic veno-occlusive disease may result from pyrrolizidine alkaloids which are contained in that kinds of herbs.All of the patients had the symptoms of ascites and abdominal distension. The mortality rate for VOD is high(42.1%),especially when jaundice is present in association with liver failure.So jaundice was a symptoms related to the graveness of the desease.HVOD was diagnosed by hepatovenography or liver biopsy. The patients with acute and subacute HVOD should receive non-operation treantment.Portosystem shunt or prota-azygous devascularization should be performed if patients have portal hypertension. Cirrhotic patients with VOD classified as Child-Pugh class C was an indication of orthotopic liver transplantation;The result showed that their percentages of total alkaloids was 0.105%;More than five alkaloids were found in the extracts of Sedum aizoon root ,among of which three types of hepatotoxic pyrrolizidine alkaloids proved to be:Senecionine,Seneciphylline,Integerrimine.The pathological signs analogized to human VOD were found in pathological examination in five mice,three(10%) from experimental group and two(6.7%) from control group ;This method can induce VOD mice models successfully.