石胆酸对肠黏膜屏障功能的影响及其机制研究

发布时间：2021-12-02 16:33

　　目的:胆总管结石为胆道外科常见疾病,轻者可无明显症状,重者可进一步发展,堵塞胆管,造成梗阻性黄疸。随着腹腔镜技术的开展,腹腔镜胆总管探查取石术（LCBDE）已经成为胆总管结石的主要治疗方式。术后胆道引流可解除胆道梗阻,降低胆道压力,减轻炎性胆汁反流,促进局部炎症消退等,但其仍存在不可忽视的并发症。梗阻性黄疸和胆汁引流后均可造成肠道内胆汁缺乏,可导致肠黏膜屏障功能的破坏,细菌和内毒素移位,引起菌血症和内毒素血症,诱导促炎细胞因子的产生（TNF-α,IL-6）,诱发全身性炎症反应综合征,可能导致多器官功能障碍综合征。肠上皮屏障主要包括机械屏障、化学屏障、生物屏障和免疫屏障。其中机械屏障是肠上皮屏障最重要的一道防线。机械屏障主要由上皮细胞和细胞间紧密连接（TJs）构成。紧密连接是一组跨膜蛋白,水闸蛋白（Claudins）、闭锁蛋白（Occludin）和膜内闭锁小带蛋白（ZOs）以及邻近的粘附连接（E-cadherin）组成,它们通过与邻近细胞相互作用形成选择性屏障。研究表明维生素D可通过激活维生素D受体（VDR）维护肠黏膜屏障功能。维生素D受体同时也是胆汁酸的感应器,胆汁中石胆酸（LCA）是... 

【文章来源】：中国医科大学辽宁省

【文章页数】：114 页

【学位级别】：博士

【部分图文】：

SD大鼠胆汁外引流和梗阻性黄疸模型

各组大鼠体重变化情况

各组大鼠肠黏膜病理变化

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