胆汁回输对梗阻性黄疸大鼠肠黏膜屏障结构与功能的直接维护作用

发布时间：2018-10-23 20:23

【摘要】：目的：探讨胆汁回输对梗阻性黄疸大鼠肠黏膜屏障功能的影响及机制。以期了解梗阻性黄疸导致的内毒素血症及肠黏膜屏障破坏与肠内胆汁的相关性。方法：健康清洁级SD大鼠40只,随机分为假手术对照组(A组,10只)、胆总管结扎组(B组,15只)和胆总管结扎回输胆汁组(C组,15只)。B、C两组建造梗阻性黄疸动物模型,A组建造假手术动物模型。C组从术后第一天起,每天进行胆汁回输(灌胃法),A、B两组术后自由饮食。各组大鼠在建模成功后第八天处死,开腹抽取腹主动脉血,检测各组大鼠血清内毒素、丙二醛(MDA)及二胺氧化酶(DAO)、水平,并切取回肠末端的肠管进行组织学检查,统计比较各组检测结果的均值。结果：血清内毒素及DAO水平：B组较A、C两组升高,差异均有统计学意义(均P0.05),A、C两组之间差异无统计学意义(P0.05)。血清MDA：B组指标较A、C两组升高,但各组间差异均有统计学意义(P0.05)。HE片光镜下观察示：B组较A、C两组出现：肠黏膜萎缩,肠绒毛出现脱落、稀少和紊乱现象,部分黏膜层与固有层分离。依据Chiu's评分标准得出：C组与B组之间有统计学差异(P0.05)。结论：胆汁对梗阻性黄疸大鼠的肠黏膜屏障结构与功能具有直接的保护及营养作用。梗阻性黄疸术后,尽早的进行胆汁回输能有效的降低血清内毒素水平,防止内毒素血症的发生,改善肠黏膜屏障功能,并减轻梗阻性黄疸带来的炎症反应和感染。梗阻性黄疸术后胆汁回输具有实用有效的临床应用价值。
[Abstract]:Objective: to investigate the effect and mechanism of bile regurgitation on intestinal mucosal barrier in rats with obstructive jaundice. Objective to study the relationship between endotoxemia and intestinal mucosal barrier damage induced by obstructive jaundice. Methods: 40 healthy and clean grade SD rats were used. They were randomly divided into sham operation control group (group A, n = 10), common bile duct ligation group (group B, n = 15) and bile duct ligation and bile transfusion group (group C, n = 15). Bile regurgitation (gavage) and free diet were performed in group A and B respectively. The rats in each group were killed on the eighth day after the model was successfully established. The abdominal aorta blood was extracted by laparotomy. The levels of serum endotoxin, malondialdehyde (MDA) (MDA) and diamine oxidase (DAO),) were measured, and the intestinal tubes at the end of ileum were removed for histological examination. The mean values of the results of each group were compared statistically. Results: the levels of serum endotoxin and DAO in group B were significantly higher than those in group A and C (P0.05), but there was no significant difference between group A and C (P0.05). The index of serum MDA:B group was higher than that of APC group, but the difference between each group was statistically significant (P0.05). Under the light microscope observation of). HE, the intestinal mucosal atrophy, intestinal villi shedding, scarcity and disorder were observed in group B than in group A and C, respectively. Part of the mucosal layer was separated from the lamina propria. According to the Chiu's score: group C and group B were statistically different (P0.05). Conclusion: bile has direct protective and nutritional effects on the structure and function of intestinal mucosal barrier in rats with obstructive jaundice. After the operation of obstructive jaundice, bile regurgitation as early as possible can effectively reduce the level of serum endotoxin, prevent the occurrence of endotoxemia, improve the intestinal mucosal barrier function, and alleviate the inflammatory reaction and infection caused by obstructive jaundice. Bile regurgitation after operation of obstructive jaundice has practical and effective clinical application value.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.3

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