| Project/Area Number |
16K10580
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Research Field |
Digestive surgery
|
|---|
| Research Institution | Nara Medical University |
|---|
Principal Investigator |
Nomi Takeo 奈良県立医科大学, 医学部, 学内講師 (50570991)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
松本 雅則 奈良県立医科大学, 医学部, 教授 (60316081)
|
|---|
| Research Collaborator |
Obara Shinsaku
|
|---|
| Project Period (FY) |
2016-04-01 – 2019-03-31
|
| Project Status |
Completed (Fiscal Year 2018)
|
| Budget Amount *help |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
|
|---|
| Keywords | ADAMTS13 / vWFマルチマー / 肝不全 / 虚血再灌流障害 / 肝切除 / Pringle法 / VWF抗原量 / UL-VWFマルチマー / UL-VWFマルチマー発現 / von Willebrand factor |
|---|
| Outline of Final Research Achievements |
This study aimed to clarify the effect of hepatectomy on UL-VWFMs. Thirty-five patients who underwent hepatectomy were eligible for the study. Multimer analysis of plasma VWF was performed. For analyses, patients were categorized according to UL-VWFM positivity after hepatectomy. The UL-VWFMs indices were significantly increased from 0.2% (0.0%-7.8%) before the operation to 4.2% (0.1%-16.3%)on postoperative day seven after the operation (p < 0.001).Seven patients remained UL-VWFMs-negative and 22 patients became UL-VWFMs-positive after operation. By multivariable analysis, Pringle’s maneuver duration was significantly associated with increased UL-VWFMs level after hepatectomy(p = 0.043). UL-VWFMs index was significantly correlated with Pringle’s maneuver duration (r = 0.444, p = 0.017). In conclusion, Plasma UL-VWFMs levels increased after hepatectomy due to ischemia-reperfusion injury with Pringle’s maneuver.
|
| Academic Significance and Societal Importance of the Research Achievements |
これまでADAMTS13, vWF, VWFマルチマーと肝切除及びPringe法との関連に着目した検討は，国内外において報告がない.本研究により，UL-VWFマルチマーと術中Pringle法による虚血再灌流障害の関連が明らかにされたことで，今後，肝切除後肝不全に対する新たな治療戦略となり得る可能性が示唆される．さらに研究がすすめば，効率的な肝切除後肝不全治療戦略となる可能性がある．ADAMTS13関連因子は病的血栓との関連から心筋梗塞や脳梗塞の治療薬としての可能性も示されており，肝臓のみならず他臓器疾患への波及効果が期待される．
|
