發(fā)布時(shí)間：2018-10-23 20:23

【摘要】：目的：探討膽汁回輸對(duì)梗阻性黃疸大鼠腸黏膜屏障功能的影響及機(jī)制。以期了解梗阻性黃疸導(dǎo)致的內(nèi)毒素血癥及腸黏膜屏障破壞與腸內(nèi)膽汁的相關(guān)性。方法：健康清潔級(jí)SD大鼠40只,隨機(jī)分為假手術(shù)對(duì)照組(A組,10只)、膽總管結(jié)扎組(B組,15只)和膽總管結(jié)扎回輸膽汁組(C組,15只)。B、C兩組建造梗阻性黃疸動(dòng)物模型,A組建造假手術(shù)動(dòng)物模型。C組從術(shù)后第一天起,每天進(jìn)行膽汁回輸(灌胃法),A、B兩組術(shù)后自由飲食。各組大鼠在建模成功后第八天處死,開(kāi)腹抽取腹主動(dòng)脈血,檢測(cè)各組大鼠血清內(nèi)毒素、丙二醛(MDA)及二胺氧化酶(DAO)、水平,并切取回腸末端的腸管進(jìn)行組織學(xué)檢查,統(tǒng)計(jì)比較各組檢測(cè)結(jié)果的均值。結(jié)果：血清內(nèi)毒素及DAO水平：B組較A、C兩組升高,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05),A、C兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。血清MDA：B組指標(biāo)較A、C兩組升高,但各組間差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。HE片光鏡下觀察示：B組較A、C兩組出現(xiàn)：腸黏膜萎縮,腸絨毛出現(xiàn)脫落、稀少和紊亂現(xiàn)象,部分黏膜層與固有層分離。依據(jù)Chiu's評(píng)分標(biāo)準(zhǔn)得出：C組與B組之間有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論：膽汁對(duì)梗阻性黃疸大鼠的腸黏膜屏障結(jié)構(gòu)與功能具有直接的保護(hù)及營(yíng)養(yǎng)作用。梗阻性黃疸術(shù)后,盡早的進(jìn)行膽汁回輸能有效的降低血清內(nèi)毒素水平,防止內(nèi)毒素血癥的發(fā)生,改善腸黏膜屏障功能,并減輕梗阻性黃疸帶來(lái)的炎癥反應(yīng)和感染。梗阻性黃疸術(shù)后膽汁回輸具有實(shí)用有效的臨床應(yīng)用價(jià)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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R657.3

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