食管灌注Lugol's碘溶液对小鼠食管和胃黏膜的损伤作用

The Effects of Lugol's Iodine Solution on the Esophageal and Gastric Mucosa of Mice

背景与目的:研究不同浓度的Lugol's碘溶液经食管灌注不同时间后,对小鼠食管和胃黏膜上皮细胞形态的影响及其导致的病理学变化。材料与方法:雄性昆明小鼠120只,分别以1%、3%、5%、7%、9%的Lugol's碘溶液于食管内灌注后,分别于2h,1d,3d及7d各处死5只,解剖食管及胃部,观察食管及胃部黏膜的肉眼改变以及组织病理学改变。结果:经食管灌注Lugol's碘溶液后2h,7%和9%的碘液灌注组小鼠,食管下段黏膜均有不同程度的红肿;灌注后3d,3%、5%、7%和9%的碘液灌注组小鼠,食管黏膜均被覆一层炎症细胞与鳞状上皮所形成的膜状物,而且随Lugol's碘溶液浓度的增高该现象越明显。去除膜状物后,可见红肿的食管黏膜上皮。灌注7d后,各浓度组小鼠的食管黏膜上皮均恢复至正常。3%、5%、7%和9%的碘液灌注后2h,小鼠胃黏膜即出现不同程度的红肿、糜烂及出血;于灌注后1d,各碘液浓度组小鼠的胃黏膜炎症反应进一步加重,为全病程最严重的时间段;于灌注后3d起,各组小鼠的胃黏膜炎症逐渐消退。各组小鼠在各时间段所出现的胃黏膜炎症反应均集中于胃前壁及大弯侧,鳞状上皮被覆的前胃炎症改变均明显轻于相应的柱状上皮被覆的胃黏膜。食管及前胃的组织病理学改变以鳞状上皮脱落及炎症细胞浸润为主。胃黏膜的组织病理学改变以前壁黏膜坏死、出血和炎细胞浸润为主。结论:食管腔内灌注Lugol's碘溶液在很低浓度时即可引起食管及胃黏膜的损伤,且随浓度的增加而加重。提示在临床上应注意使用Lugol's碘溶液的浓度。

BACKGROUND ＆ AIM： The morphological and pathological changes of the esophageal and gastric epithelium in mice treated with different concentrations of Lugol＇ s iodine solution were investigated. MATERIALS AND METHODS： 1%, 3%, 5%, 7%, 9% of Lugol＇ s iodine solutions were perfused into the esophagus of 120 male Kunming mice. Five mice each were killed at 2 hours, 1 day, 3 days and 7 days after Lugol＇s iodine treatment. The pathological changes of the esophagus and the stomach were examined. RESULTS： Two hours after esophageal perfusion with 7% and 9% Lugol＇s iodine solution, oedema of different degree was found in the lower part of esophageal mucosa of the mice. Three days after perfusion with 3% ,5% ,7% and 9% Lugol＇s iodine solution, the esophageal epithelia of the mice were covered by a coating. The coating was a mixture of inflammatory cells and squamous epithelium. It became more obvious with the increasing concentration of Lugol＇s iodine solution. The esophageal epithelium was red and oedematous after the coating was taken away. Seven days after perfusion, the esophageal epithelium recovered in all the five groups. Two hours after esophageal perfusion with 3% ,5%,7% and 9% Lugol＇s solution, oedema, ulceration and haemorrhage of different degrees were found in the gastric mucosa. One day later, the inflammation became more serious.Three days after perfusion, the inflammation subsided gradually. The inflammatory reaction of the gastric epithelium in different groups and at different periods were all concentrated on the anterior wall and the greater curvature, with which the Lugol＇ s iodine solution made contact during perfusion. The inflammation in the fore stomach which was covered with squamous epithelium was obviously less severe than that of gastric mucosa with columnar epithelium. The pathological changes of the esophagus and fore stomach consisted of exfoliafion of the squamous epithelium and infiltration of inflammatory cells. The changes of the gastric mucosa showed necrosis, haemorrhage, and infiltration of inflammatory cells on the anterior wall. CONCLUSION： Lugol＇ s iodine solution perfused into the esophagus could damage the mucosa of the esophagus and stomach even at very low concentration. The damage became worse with increase of the concentration.