兔小肠结扎梗阻早期对肝脏的损伤

liver damaged by intestinal ligation and obstruction early in rabbit

目的 探讨急性完全性小肠梗阻对肝脏的损害及机理。方法 利用家兔小肠末端结扎梗阻模型在不同时相观测肝脏受损的形态学改变及测定血清谷丙转氨酶(ALT)和线粒体谷草转氨酶(MGOT)浓度。结果 在肠结扎后12h,通过电镜观测到肝细胞及其线粒体、肝窦内皮细胞和贮脂细胞的损伤性改变,血清ALT和MGOT浓度显著升高,随着病程的进展,上述肝脏受损性改变逐渐加重,肠结扎36h时几乎肝细胞所有线粒体严重受损。结论 急性完全性小肠梗阻时肠粘膜屏障功能受损,大量细菌和毒素率先进入肝脏,早期导致肝脏受损,这种损伤随病程的进展逐渐加重,这可能是导致多系统器官衰竭的重要机理之一,提示肝功能的保护在急性肠梗阻的救治中至关重要。

Objective To study the liver damaged by intestinal obstruction and its mechanism. Methods Small intestin is ligated in rabbit, then observed pathological evolution of the liver by electron microscope and tested concentrations of serum alamine aminotransferse (ALT)and mitochondrial glutamicoxaloacetic transaminase ( MGOT) . Results Sign of damage to hepatocyte and its mitochondria was found by electron microscope and concentrations of ALT and MGOT in serum increased markedly 12 hours after intestinal ligation.The damage became more severe as intestinal obstruction prolonged. Nearly no normal mitochondria of hepatocyte was found 36 hours after intestinal ligation. Conclusions Liver can be early and seriously damaged as acute intestinal obstruction prolonged. This may be an important reason of occurence of MSOF, so to protect liver against damage is very important during the treatment of acute intestinal obstruction.