经导管肝动脉灌注化疗栓塞所致急性肝损伤机制及保肝研究
发布时间：2021-08-26 03:47
原发性肝癌（primary liver cancer,PLC）的高发性与高致死性,严重危害了我国人民的生命健康。经导管肝动脉灌注化疗栓塞（transcatheter arterial chemoembolization,TACE）是非手术治疗中晚期PLC首选方法。TACE术后最常见并发症是急性肝损伤（acute liver injury,ALI）,严重肝损伤患者会出现黄疸、腹水、肝性脑病,甚至急性肝功能衰竭等导致治疗相关性死亡。如何减少TACE所致ALI,进一步改善患者的生活质量并延长生存期,一直是临床上治疗中晚期PLC的热点和难点问题。TACE包括肝动脉灌注化疗和栓塞,造成ALI的主要原因为:（1）动脉灌注化疗药物所致药物性肝损伤（drug-induced liver injury,DILI）,研究显示化疗药物及药物在代谢过程中所产生的亲电子产物,可促使线粒体产生大量活性氧自由基（reactive oxygen species,ROS）,造成氧化应激性肝损伤。（2）栓塞剂所致肝损伤,TACE术中常因肿瘤供养血管扭曲、打折导致难以完成超选择性灌注化疗栓塞（superselective ...
【文章来源】：河北医科大学河北省
【文章页数】：155 页
【学位级别】：博士
【部分图文】：
小鼠肝脏组织切片的H&E染色及组织损伤评分比较（x±s）
图 2 小鼠心脏组织切片的 H&E 染色及组织损伤评分比较（x±s）ig.2 Comparison of H&E staining and the injury scores of heart histologice ( x ±s).Note: The heart tissue showed structural integrity in the norntrol group (Control). The cardiomyocytes showed disordered arrangemstructive structure, some degeneration and necrosis in the DOX grlack arrow). The myocardial cells returned to normal in the Me-treatment groups, almost with no difference compared with normal conoup. L-MgIG group included rare slightly swollen cells (black arrow). ale bar represented 50 μm (original magnification, 400×). The cartogramrdiac tissue injury scores showed: **P＜0.01 vs DOX group;##P＜0.01ontrol group; Comparison among the intervention groups (L-MgIG gro-MgIG group, H-MgIG group) , P＜0.01.
图 3 Bax、Bcl-2 蛋白在小鼠肝脏组织中的表达（x±s）Fig.3 Expression of Bax and Bcl-2 protein in liver tissue of mice (x±s)ote:1. Normal control group (Comtrol), 2. L-MgIG group, 3. M-MgIG gr. H-MgIG group, 5. DOX group. There is a certain amount of Bax, Botein expression in the liver tissue of the normal control group. Compith normal control group, the expression of Bax protein significahanced and the expression of Bcl-2 was significantly decreased in Doup. Compared with DOX group, intervention group significantly decrepression of Bax protein and increased the expression of Bcl-2 protein ncentration dependent manner. Cartogram representation: **P ＜ 0.01OX group;##P＜0.01 vs Control group; Comparison among the intervenoups (L-MgIG group, M-MgIG group, H-MgIG group) , P＜0.01.
【参考文献】：
期刊论文
[1]原发性肝癌经导管肝动脉化疗栓塞术后应用不同保肝方案的效果比较研究[J]. 武中林,吴勇超,杨超,吴建华,李顺宗,杨光,李智岗. 中国全科医学. 2017(23)
[2]原发性肝癌诊疗规范（2017年版）[J]. National Health and Family Planning Commission of the People’s Republic of China;. 临床肝胆病杂志. 2017(08)
[3]原发性肝癌的抗血管生成靶向治疗现状与挑战[J]. 陈丹,王凯冰,李加桩,隋红. 中国肿瘤. 2017(03)
[4]18β-甘草次酸对肝癌HepG2细胞增殖及PI3K、PDK1、AKT蛋白表达的影响[J]. 金鑫,李慧,李刚,赵海燕. 山东医药. 2017(03)
[5]河北省肝癌发病和死亡40年变化趋势分析[J]. 师金,李道娟,梁迪,靳晶,温登瑰,贺宇彤. 肿瘤防治研究. 2016(11)
[6]肝脏缺血再灌注损伤中线粒体膜氧化应激和电生理功能障碍的分子机制研究[J]. 金涛,王兴强,刘超. 天津医药. 2016(11)
[7]中药单体治疗原发性肝癌实验研究进展[J]. 张少鹏,姚树坤,宋威江,李蕊. 中日友好医院学报. 2016(05)
[8]肝动脉化疗栓塞术（TACE）对原发性肝癌患者的肝功能影响及相关因素分析[J]. 贺爱军,任羽,姬乐,吴耀禄. 中国实验诊断学. 2016(09)
[9]肝癌综合介入治疗研究进展[J]. 杜松,郭应兴. 现代临床医学. 2016(05)
[10]TACE治疗原发性肝癌对肝功能的影响及相关因素的研究[J]. 王甦,黄一枫,刘佳,周年兰. 胃肠病学和肝病学杂志. 2016(08)
本文编号：3363482
【文章来源】：河北医科大学河北省
【文章页数】：155 页
【学位级别】：博士
【部分图文】：
小鼠肝脏组织切片的H&E染色及组织损伤评分比较（x±s）
图 2 小鼠心脏组织切片的 H&E 染色及组织损伤评分比较（x±s）ig.2 Comparison of H&E staining and the injury scores of heart histologice ( x ±s).Note: The heart tissue showed structural integrity in the norntrol group (Control). The cardiomyocytes showed disordered arrangemstructive structure, some degeneration and necrosis in the DOX grlack arrow). The myocardial cells returned to normal in the Me-treatment groups, almost with no difference compared with normal conoup. L-MgIG group included rare slightly swollen cells (black arrow). ale bar represented 50 μm (original magnification, 400×). The cartogramrdiac tissue injury scores showed: **P＜0.01 vs DOX group;##P＜0.01ontrol group; Comparison among the intervention groups (L-MgIG gro-MgIG group, H-MgIG group) , P＜0.01.
图 3 Bax、Bcl-2 蛋白在小鼠肝脏组织中的表达（x±s）Fig.3 Expression of Bax and Bcl-2 protein in liver tissue of mice (x±s)ote:1. Normal control group (Comtrol), 2. L-MgIG group, 3. M-MgIG gr. H-MgIG group, 5. DOX group. There is a certain amount of Bax, Botein expression in the liver tissue of the normal control group. Compith normal control group, the expression of Bax protein significahanced and the expression of Bcl-2 was significantly decreased in Doup. Compared with DOX group, intervention group significantly decrepression of Bax protein and increased the expression of Bcl-2 protein ncentration dependent manner. Cartogram representation: **P ＜ 0.01OX group;##P＜0.01 vs Control group; Comparison among the intervenoups (L-MgIG group, M-MgIG group, H-MgIG group) , P＜0.01.
【参考文献】：
期刊论文
[1]原发性肝癌经导管肝动脉化疗栓塞术后应用不同保肝方案的效果比较研究[J]. 武中林,吴勇超,杨超,吴建华,李顺宗,杨光,李智岗. 中国全科医学. 2017(23)
[2]原发性肝癌诊疗规范（2017年版）[J]. National Health and Family Planning Commission of the People’s Republic of China;. 临床肝胆病杂志. 2017(08)
[3]原发性肝癌的抗血管生成靶向治疗现状与挑战[J]. 陈丹,王凯冰,李加桩,隋红. 中国肿瘤. 2017(03)
[4]18β-甘草次酸对肝癌HepG2细胞增殖及PI3K、PDK1、AKT蛋白表达的影响[J]. 金鑫,李慧,李刚,赵海燕. 山东医药. 2017(03)
[5]河北省肝癌发病和死亡40年变化趋势分析[J]. 师金,李道娟,梁迪,靳晶,温登瑰,贺宇彤. 肿瘤防治研究. 2016(11)
[6]肝脏缺血再灌注损伤中线粒体膜氧化应激和电生理功能障碍的分子机制研究[J]. 金涛,王兴强,刘超. 天津医药. 2016(11)
[7]中药单体治疗原发性肝癌实验研究进展[J]. 张少鹏,姚树坤,宋威江,李蕊. 中日友好医院学报. 2016(05)
[8]肝动脉化疗栓塞术（TACE）对原发性肝癌患者的肝功能影响及相关因素分析[J]. 贺爱军,任羽,姬乐,吴耀禄. 中国实验诊断学. 2016(09)
[9]肝癌综合介入治疗研究进展[J]. 杜松,郭应兴. 现代临床医学. 2016(05)
[10]TACE治疗原发性肝癌对肝功能的影响及相关因素的研究[J]. 王甦,黄一枫,刘佳,周年兰. 胃肠病学和肝病学杂志. 2016(08)
本文编号：3363482
本文链接：https://www.wllwen.com/yixuelunwen/zlx/3363482.html
