断流术对肝硬变门脉高压大鼠胃粘膜影响的研究

Studies of the functional and morphological changes of gastric mucosa after portoazygos disconnection in cirrhotic portal hypertension in rats

通过实验，观察了肝硬变门脉高压大鼠在断流术后胃粘膜结构和功能改变。结果显示门脉高压时胃窦及底体部胃粘膜血流量（ＧＭＢＦ）、糖蛋白（ＧＰ）及ＰＧＥ２、６－酮－ＰＧＦ１α等均明显下降，胃粘膜上皮细胞脱落，粘膜下层水肿、厚度增加、毛细血管腔缩小。断流术后上述指标则进一步降低，胃粘膜上皮呈显著缺血、缺氧表现。以上结果表明，肝硬变门脉高压时胃粘膜防御能力被削弱，导致胃粘膜病变的发生，断流后则进一步损害了胃粘膜的防御功能，可能是断流术后再出血的原因之一。

The functional and morphological changes of the gastric mucosa after portoazygos disconnection in cirrhotic portal hypertension were observed in rats. It was found that the gastric mucosal blood flow (GMBF)and the level of glycoprotein(GP)and prostaglandins(PGE2 and 6-keto-PGF1 a)of the gastric corpus and antrum were significantly lower in portal hypertension than in the control.There were desquamation of the epithelial cells of the gastric mucosa,edema and thickening of the submucosal layer and narrowing of the capillaries in cirrhotic portal hypertension,After the disconnection of the portoazygos junction,the above findings became more prominant.The epithelium of the gastric mucosa was obviously ischemic and hypoxic.These findings suggest that in cirrhotic protal hypertension,the defensive capacity of the gastric mucosa is weakens the result in the pathological changes of the gastric mucosa. The portoazygos disconnection further weakens the defensive capacity of the gastric mucosa,which might be one of the causes of high rate of hemorrhage after disconnection.