Кількісний морфологічний аналіз структурної перебудови ендотеліоцитів артеріального і венозного русел порожньої кишки при резекції різних об’ємів паренхіми печінки

Abstract

В експерименті на лабораторних білих щурах встановлено, що резекція 58,1 % паренхіми печінки призводить до пострезекційної портальної гіпертензії і вираженої структурної перебудови ендотеліальних клітин артеріального і венозного русел порожньої кишки, яке характеризується нерівномірними, диспропорціональними змінами морфометричних параметрів їх цитоплазми і ядер, порушеннями відношень між ними, значним зростанням відносних об’ємів пошкоджених ендотеліоцитів. Вираженість структурних змін ендотеліоцитів домінує у венах порожньої кишки і залежить від видаленого об’єму паренхіми печінки.

В эксперименте на лабораторных белых крысах установлено, что резекция 58,1% паренхимы печени приводит к пострезекционной портальной гипертензии и выраженной структурной пере- стройки эндотелиальных клеток артериального и венозного русел тощей кишки, характеризующейся неравномерными, диспропорциональными изменениями морфометрических параметров цитоплазмы и ядер эндотелиоцитов, нарушениями отношений между ними, значительным ростом относительных объемов поврежденных эндотелиоцитов. Выраженность структурных изменений эндотелиоцитов доминирует в венах тощей кишки и зависит от удаленного объема паренхимы печени.

Liver resection is widely used in modern surgical departments. Removal of large volumes of the liver leads to postresection portal hypertension, which is complicated by bleeding from varicose veins of the esophagus, stomach, rectum, ascites, splenomegaly with secondary hyperpselinism, parenchymal jaundice and portosystemic encephalopathy. The widespread prevalence of this pathology, high mortality from its complications indicates that it is an important medical and social problem. Resections of large volumes of liver parenchyma are complicated by postresection portal hypertension, which leads to structural and functional changes in the organs of the basin portal hepatic vein. The features of the structural reconstruction of endotheliocytes of arterial and venous beds jejunum after resection of different volumes of liver parenchyma have not been adequately investigated. The purpose of the research was morphometrical investigate the structural reconstruction of endotheliocytes of arterial and venous beds jejunum after resection of different volumes of liver parenchyma. Methods and material. The research was conducted on 45 male rats, which were divided into 3 groups. The group 1 consisted of 15 intact animals, 2-15 rats after resection of the left lateral part – 31.5 % of liver parenchyma, 3 – 15 animals after resection of the right and left side parts of the liver (58.1 %). Euthanasia of animals was carried out by bloodletting in conditions of thiopental anesthesia 1 month after the beginning of the experiment. The cut pieces of the jejunum were fixed in a 10 % neutral formalin solution, and after appropriate ethyl alcohol of increasing concentration was poured in paraffin blocks. Histologic sections 5-7 μm thick after deparaffinization were stained with hematoxylin-eosin, for van Gizon, Mallory, Weigert, and toluidine blue. Morphometrical determined the height of the endothelial cells, the diameter of their nuclei, the nuclear-cytoplasmic rations in the endothelial cells and the relative volume of damaged endothelial cells in arteries and veins. Quantitative indicators were processed statistically. Results and discussion. One month after resection of 31.5 % of the liver, the height of the endothelial cells, the diameter of their nuclei, the nuclear-cytoplasmic rations in the endothelial cells and the relative volume of damaged endothelial cells in arteries and veins of the jejunum changed slightly. Resection of 58.1% of liver parenchyma leads to postresection portal hypertension and severe structural rearrangement of endothelial cells of the arteries and veins of the jejunum. The height of the endothelial cells in the arteries decreased by 9.6 %, the diameter of their nuclei- by 5.7 %, the nuclear-cytoplasmic ratios increased by 9.3%, the relative volume of damaged endothelial cells-by 21.3 times, in the venous beds of the jejunum the indicated changes were 10.2%, 7.0%, 7.1% and 21.7 times, respectively. The severity of structural changes in endothelial cells dominates the veins of the jejunum and depends on the removed volume of liver parenchyma. Conclusion. Researches was found that a resection of 58.1% of the liver parenchyma leads to postresection portal hypertension and severe structural reconstruction of the endothelial cells of the arterial and venous beds of the jejunum, characterized by uneven disproportionate changes in the morphometric parameters of their cytoplasm and nuclei, a violation of the relations between them, significant an increase in the relative volume of damaged endothelial cells. The severity of the structural reconstruction of endothelial cells dominates the veins of the ileum and depends on the volume of the removed parenchyma of the liver.