王英杰 李梦东 王宇明 聂青和 陈国致 黄艳萍 400038,重庆,第三军医大学西南医院 中华肝脏病杂志 1999 0 7 1


    关键词：肝衰竭，暴发性 生物人工肝 人工肝支持 期刊 zhgzbzz 0 基础研究 fur -->


    

摘要 目的 构建理想的体外生物人工肝支技系统(EBLSS)，探讨其对暴发性肝衰竭(FHF)的支持作用。方法 用经体外两步灌流法分离，限制贴壁技术球形聚集混合培养的人肝细胞-肝非实质细胞与中空纤维型生物反应器及由血液透析仪改装的辅助循环装置共同构建的EBLSS，对门腔静脉分流加入肝血液阻断法建立的FHF模型犬进行人工肝支持实验。结果 在平均约108肝细胞-肝非实质细胞EBLSS的支持下，治疗组犬存活时间较无细胞空白循环对照组延长近一倍[分别为(5.8±0.5)小时和(10.7±1.1)小时]，其血压、心率、心电图等改变较迟缓。在EBLSS循环5小时内，支持组血氨、乳酸升高亦无对照组明显，两组犬3小时和5小时的血氨、乳酸变化有显著差异(P<0.01)。所用细胞均保持较好的活力和贴壁能力。结论 所建EBLSS已发挥出培养肝细胞的生物合成与解毒代谢作用，能够部分代偿FHF的肝脏功能，将有可能为临床FHF及重型肝炎患者提供有效的人工肝支持和治疗。

    

Liver support effect ofexperimental extracorporeal bioartificial liver

WANG Yingjie,LI Mengdong,WANG Yuming,etal.

Southwest Hospital,Third MilitaryMedical College,Chongqing 400038

Abstract Objective Toestablish an extracorporeal bioartificial liver support system (EBLSS) and study itssupport effect for fulminant hepatic failure (FHF).Methods The EBLSSconsists of three parts: human liver cells (hepatocytes,nonparenchymal hepatocytes)isolated and cultured by extracorporeal two-stage perfusion and spheroidal aggregatesmethods respectively,hollow fiber bioreactor,and supple-mentary circulation unit,which wasemployed to support the FHF model dogs.Results Compared with the controldogs treated with EBLSS but without liver cells,the survival time of artificial liversupport dogs was significantly prolonged,the changes of blood pressure,heart rate and ECGwere slower,and the serum ammonia and lactate levels were significantly lower at the 3 and5 hr.In addition,a good viability of human liver cells was noted after 5 hr experiment.Conclusion This EBLSS has played the metabolic role of cultured heman hepatocytes,is capable ofcompensating the function of the liver,and might provide effective artificial liversupport and therapy for patients with FHF or severe hepatitis.

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