兔胆囊切除术后Oddi括约肌离体运动功能变化的 - 第三军医大学学报.DOC

兔胆囊切除术后Oddi括约肌离体收缩及肌球蛋白重链表达变化 何谦 李智华 王铁虎 熊燕 刘永康 张志波 西南医院全军肝胆外科研究所 重庆 400038 【摘要】：目的 探讨兔胆囊切除术后Oddi括约肌(Sphincter of Oddi, SO)自身发生的适应性变化。方法 将60只成年新西兰大白兔分为4组，A组、D组各18只，B、C组各12只。对照组（A组）采取假手术方式，开腹暴露胆囊后关腹，饲养8周。实验组（B，C，D组）分别为完整切除胆囊后饲养2、4、8周。实验毕将兔麻醉后取出oddi括约肌，分别取A、B、C、D组各12只经离体测压后提取总蛋白通过western blot蛋白检测肌球蛋白重链表达变化，另分别取A、D组中6只行免疫组化检测肌球蛋白重链表达变化。结果：B,C,D组Oddi括约肌离体收缩压及肌球蛋白重链表达相较A组均逐渐增加，且有统计学意义（P0.01），免疫组化示D组相较A组平滑肌细胞肌球蛋白浓染。结论：胆囊切除术后oddi括约肌发生了适应性收缩能力增强并且肌球蛋白重链表达上调，这可能是胆囊切除术后患者oddi括约肌功能障碍多发生障碍的病理基础之一。 【关键词】 胆囊切除术后；oddi括约肌；离体测压；肌球蛋白重链。 Change of Oddi motility in vitro and MHC in sphincter of oddi after cholecystectomy. He Qian, Wang Tie-hu, Xiong Yan, Li Zhi-hua. Institute of Hepatobiliary Surgery Southwest Hospital. Third Military Medical University, Chongqing 400038, China. 【Abstract】 Objective: To investigate the alteration of rabbit’s sphincter of oddi after cholecystectomy. Methods: 60 adult rabbits were separated into 4 groups，A and D groups are each 18, C and D are each 12. In the post cholecystectomy group(B,C,D groups), rabbits were operated cholecystectomy and brood for 2, 4 and 8 weeks, while in the control group(A group), only sham operation were done and brood for 8 weeks. Then the rabbits’ sphincter of oddi were dislodged in drugged state, 6 rabbits of A and D groups were examed by immunohistochemistry and 12 rabbits of all groups were gotten motility in vitro and MHC express examination by western blot. Results: amplitude increased and MHC express more in B,C,D groups rather then A group significantly (P0.01). and control to A group, the tinction of D group MHC deepen. Conclusion: SO was adaptive changed after cholecystectomy, maybe it is one of the etiopathogenisis that why most of the clinical data concerning SO disfunction has been obtained from postcholecystectomy patients. 【Key words】postcholecystectomy; sphincter of oddi; motility in vitro ;MHC. 临床经验及研究证实，oddi括约肌功能障碍综合征（Shincter of oddi disfunction, SOD）多发于胆囊切除术后[1,2]，胆囊与oddi括约肌（Sphincter of Oddi,