梗阻性黄疸大鼠血液中内毒素含量与组织形态学变化.DOCVIP

临床医学论文-梗阻性黄疸大鼠血液中内毒素含量与组织形态学变化 ??????????????? 作者：姜宪，姜旭，申蓉硕，张虎 ［摘要］ ［目的］ 探讨梗阻性黄疸大鼠血液中内毒素含量与肝及小肠黏膜的形态学变化. ［方法］ 监测假手术组、梗阻性黄疸1，2周组小鼠血胆红素及内毒素含量，采用光学显微镜及电子显微镜观察不同时期梗阻性黄疸大鼠肝及小肠黏膜的形态学变化. ［结果］ 梗阻性黄疸1，2周组大鼠血胆红素及内毒素含量明显升高，与假手术组比较有显著性差异，且肝组织损伤随梗阻时间的延长而逐渐加重，但肠道黏膜的损伤则较轻微. ［结论］ 发生梗阻性黄疸时内毒素血症的发生和发展与肠黏膜的屏障功能密切相关. 　　［关键词］? 梗阻性黄疸;内毒素血症;组织学 ??? ABSTRACT:OBJECTIVE To study the the content of plasma endotoxin and the histomorphological changes of liver and small intestinal membrane caused by obstructive jaundice in rats.METHODS After executing rats in obstructive jaundice groups for1，2weeks and pseudo operative group with bleeding，the content of serum bilirubin and endotoxin was monitored and the histomorphological transformation of the liver and the small intestine was observed in different period of obstructive jaundice by light microscope and electron microscope.RESULTS The content of serum bilirubin and endotoxin in the obstructive jaundice groups for1，2weeks was obviously increased，respectively，and there was significant difference compared with pseudo operative group.The damage of liver was becoming heavier while the obstruction was prolonged，but the damage of the small intestinal membrane was much slighter.CONCLUSION When happening obstructive jaundice，the occurring and the development of endotoxemia is closely correlated with the protective barrier function of small intestinalmembrane in rats. ???　 Key words:obstructive jaundice;endotoxemia;histology? 　?梗阻性黄疸是常见的外科疾病，而因肝网状内皮系统功能受抑制及肠黏膜屏障功能降低所并发肠源性内毒素血症是造成患者死亡的主要原因.本实验通过建立梗阻性黄疸动物模型，动态观察了其血液中内毒素含量与肝及小肠黏膜的形态学变化，探讨了肝网状内皮系统及肠黏膜的屏障功能在梗阻性黄疸所致内毒素血症中的作用. ??? 1 材料与方法 ??? 1.1 材料? 选取健康Wistar雄性大鼠，体重为（215±35）g，由延边大学医学部实验动物科提供. 　?1.2 方法 ??? 1.2.1 动物模型的制作? 选取健康Wistar雄性大鼠30只，随机分成3个组，即假手术组及梗阻性黄疸1，2周组，每组各为10只.实验大鼠术前禁食禁水12h，用10g/L氯胺酮按每kg体重100mg的剂量进行腹腔内注射麻醉.梗阻性黄疸1，2周组取上腹部正中切口开腹，沿肝十二指肠韧带找到胆总管，在十二指肠上方用7号线双重结扎胆总管，制作梗阻性黄疸模型;假手术组仅进行腹腔游离，不结扎胆总管.于术后第7，14日取血，处死动物. ??? 1.2.2 血清胆红素含量的测定? 取1mL血液置于试管中，以2500r/min离心10min，取血清，用苯甲酸钠-咖啡因比色法测定血清胆红素含量. ??? 1.2.3 血液中内