长期胆汁反流对大鼠胃黏膜的影响

Effect of long-term bile reflux on rat gastric mucosa

目的研究长期胆汁反流对大鼠胃黏膜的影响。方法反流组大鼠91只,于胆总管开口水平以下横断十二指肠。并将前胃与空肠吻合,建立胆汁反流大鼠模型,对照组大鼠12只未手术,1年后予胃部病理检查。结果反流组大鼠13只存活满1年。大鼠前胃鳞状上皮基底细胞增生,黏膜下血管增多、扩张、充血,黏膜基底部和黏膜下中、重度慢性炎症.呈轻度活动性。腺胃胃体小凹增生,泌酸腺底部扩张,黏膜表层轻度慢性炎症,无活动性,黏膜基底部和黏膜下轻度慢性炎症,活动性为轻度。胃窦小凹增生,1只大鼠呈轻度不典型增生,1只有高分化管状腺癌伴黏膜下层骨化生,黏膜基底部和黏膜下轻度慢性炎症,无活动性。结论长期胆汁反流能导致腺胃柱状上皮和前胃鳞状上皮增生,并逐渐加重,终具有致癌作用。

Objective To investigate the effect of long-term bile reflux on rat gastric mucosa. Methods Ninty one model rats of bile reflux were established by transecting the duodenum below the level of the outlet of common bile duct and anastomosing the forestomach and jejunum. Twelve nonoperated rats severed as control. The pathologic changes of the gastric mucosa were studied one year later. Results Histopathological changes of gastric mucosa in 13 rats in model group included basal cell hyperplasia, vascular hyperplasia, enlargement and congestion in submucosa, and moderate to severe chronic inflammation with mild activity in the base of mucosa and submucosa in the forestomach. Foveolar hyperplasia, expanding of the base of oxyntic gland, mild chronic inflammation without activity in the upper mucosa, and mild chronic inflammation with mild activity in the base of mucosa and submucosa in the body of glandular stomach were found. Foveolar hyperplasia, one with mild dysplasia, one with high grade glandular adenocarcinoma in the glandular antrum were demonstrated. Conclusions The study indicate that long-term bile reflux can induce the hyperplasia both in columnar epithelium in the glandular stomach and squamous epithelium of forestomach with a time related progression and result in gastric carcinogenesis .