兔肝外胆道内脏感觉传导途径的实验研究

Research of visceral sensory pathway in rabbit bile duct

目的:通过动物造模观察与内脏痛相关核团中C-fos、一氧化氮合酶(NOS)的表达,探讨内脏感觉传导途径。方法:新西兰大白兔36只,随机分为假手术a组、假手术b组、胆管注射大肠杆菌组、胆囊内注射大肠杆菌组、胆管扩张组、扩张Oddis括约肌组共6组,每组6只,取脊髓、脑干以及间脑作连续切片后,采用HE染色光镜定位及免疫组织化学技术检测各组脑和脊髓不同部位C-fos、NOS的表达,并进行比较。结果:胆管注射大肠杆菌组、胆囊内注射大肠杆菌组在脊髓(C5-7、T6-9)后角、薄束核、楔束核、丘脑腹后外侧核、孤束核中NOS的阳性表达明显高于假手术a组(P<0.05);胆管扩张组脊髓(C5-7、T6-9)后角、薄束核、楔束核、孤束核、丘脑腹后外侧核中C-fos的阳性表达明显高于假手术b组(P<0.05);扩张Oddis括约肌组脊髓后角(C5-7)和孤束核中C-fos的阳性表达明显高于假手术b组(P<0.05)。结论:胆囊和胆管引起的疼痛均与脊髓(C5-7、T6-9)后角、薄束核、楔束核、丘脑腹后外侧核、孤束核有关,推测由交感和迷走神经双重支配;Oddis括约肌引起的疼痛与孤束核有关,推测由迷走神经传入。

Objective： To observe the express which associate with NOS and C-fos in visceral pain, and discuss the visceral sensory pathway. Methods： A classical animal model of New Zealand rabbits was established by imitation. 36 healthy rabbits were randomly divided into 6 groups, each group was 6, namely. the group of dummy operation a;the group of dummy operation b; the group of inject O111B4 in bile duet; the group of inject O111B4 in gallbladder; expand bile duct group; expand Oddi＇s constrictor group. After fetch spinal cord, brain stem and diencephalons to slid, location under the microscope by using H-E staining. Use immunocytochemistry to reveal interrelated nucleus with NOS and C-los, and dispose the data with statistics. Results： In the group of inject OlnB4 in bile duct and the group of inject O111B4 in gallbladder, NOS had expressed in posterior horn（T5-7）, nucleus of solitary tract higher than in the group of dummy operation （P d0.05） ; In the group of expand bile duct group, C-fos had expressed in posterior horn （C5-7, T7-9）, racile nucleus, cuneate nucleus, ventral posterolateral nucleus, nucleus of solitary tract higher than in the group of dummy operation （P %0.05） ; In the group of expand Oddi＇s constrictor group, C- fos had expressed in posterior horn（C5- 7）, nucleus of solitary tract higher than in the group of dummy operation （P 〈0.05）. Conclusions： The ache arosed by gallbladder and bile duct are related with posterior horn（C5-7 , T7-9）, racile nucleus, cuneate nucleus, ventral posterolateral nucleus, nucleus of solitary tract, we could presume them be dominated by both sympathetic and pneumogastric nerve. The ache arosed by Oddis constrictor are related with nucleus of solitary tract, and presume it be dominated by pneumogastric. C-fos had lower expressed in C5-7 when set up the imitation and cut off right midriff nerve, these compare with group Oddi＇s constrictor, have statistical significance, presume the afferent nerve of gallbladder consist of visceral nerves and right midriff nerve.