摘要
目的通过动物实验观察在胆道不同状态下逆行胆管造影对机体的影响．方法日本大耳白兔５１只随机分成６组，模拟胆道不同状态制作动物模型，即正常对照组５只，造影组５只，梗阻组７只，造影后梗阻组７只，梗阻后造影再梗阻组１３只，梗阻后造影解除梗阻组１４只，分别作逆行胆管造影．除造影组在注射造影剂后２４ｈ采集标本外，其它各组均在胆管测压后进行．测定门脉血中氧自由基、内毒素及胃动素，肝组织ｃＡＭＰ及脑组织β内啡肽含量．结果造影组与对照组相比各项指标无明显改变．梗阻状态下造影后继续梗阻组与对照组相比各项指标均有改变，表现在内毒素、氧自由基、β内啡肽、胃动素、肝脏ｃＡＭＰ明显升高．及时解除梗阻表现为氧自由基含量明显下降（Ｐ＜００５），内毒素含量呈下降趋势．结论生理状态下胆管造影对机体无任何不良影响．胆道梗阻状态下造影，机体的改变主要与梗阻本身有关，适时有效减压能使梗阻引起的损害逐渐好转．
AIM To study the systemic effects of cholangioghaphy in different conditions of bile duct in animal experiment. METHODS Fifty one rabbits were divided into six groups randomly in order to make different pathophysiological conditions of the bile duct. Normal control group ( n =5), cholangiography group ( n =5); obstructed group ( n =7), cholangiography+obstructed group ( n =7), obstructed+cholangiography+reobstructed ( n =13); obstructed+cholangiography+disobstructed group ( n =14). Cholangiography was performed in each group. Samples were collected after the pressure of bile duct was measured in all groups except for one group 24 hours after cholangiography. Oxygen free radical, endotoxin, gastral motolin, hepatic cAMP, β endophin in brain were also detected. RESULTS There was no obvious change in various parameters in cholangiography group compared with the control group. Oxygen free radical ( P <0 01), endotoxin ( P <0 01), gastral motolin ( P <0 01), β endophin ( P <0 05), hepatic cAMP ( P <0 05) became significantly higher in the obstructed+cholangiography+reobstructed group than the control group. Timely depression of bile duct pressure showed that the oxygen free radical level declined obviously ( P <0 05) and endotoxin showed a falling tendency. CONCLUSION Cholangiography in physiologic state has no adverse effect on the organism, and under the obstructive condition of bile duct, the pathologic changes were mainly related to the obstruction itself. Timely and effective depression of bile duct pressure could improve this injury process.
