慢性门脉高压鼠胃微血管扩张与粘膜细胞动力学的关系

Relationship between ectasias in gastric microvascular system and cytokinetics in gastric mucous epithelial cell group in PHG-MH rats

目的探讨慢性型门脉高压条件下胃微血管系统扩张瘀血与粘膜上皮细胞群体（ＧＭＥＣＧ）增殖动力学状态的关系．方法用３０ｇ／Ｌ硫代乙酰胺腹部ｓｃ法诱导大鼠慢性肝损害肝硬变及门脉高压，继用饥饿诱导法使大鼠发生门脉高压性胃粘膜出血（ＰＨＧＭＨ，ｎ＝３４），用形态测量法及微观放射自显影技术分期观察（注药４５ｄ，ＰＨＴＭＨⅠ，ｎ＝１４；注药６５ｄ，ＰＨＴＭＨⅡ，ｎ＝２０）模型鼠的胃粘膜微血管直径（ＤＧＭＭ）、粘膜下小静脉管径比（ＰＳｍＶＤ）、粘膜下厚度（ＳｍＴ）及粘膜上皮细胞群体标记指数（ＬＩ）的变化．结果①ＰＨＧＭＨ鼠出血率（９１２％）及严重性分级（２２７±０２０级）均大于对照（Ｐ＜００１），分期观察出血率（８５７％和９５０％）及严重性分级（１７９±００３级和２６０±０２５级）均大于对照（Ｐ＜００５和Ｐ＜００１）．②ＰＨＧＭＨ鼠ＤＧＭＭ（４０１μｍ±３０μｍ）、ＰＳｍＶＤ（０５０±００３）均大于对照（Ｐ＜００５和Ｐ＜００１）．分期观察ＰＨＧＭＨⅠ鼠ＤＧＭＭ和ＰＳｍＶＤ未达显著水平；而ＰＨＧＭＨⅡ鼠ＤＧＭＭ（４３８μｍ±４２０μｍ）、严重性分级（２６０±０２?

IM Abstract:To investigate the relationship between ectasias of the gastric microvascular system (GMS) and cytokinetics of the gastric mucous epithelial cell group (GMECG) during the development of portal hypertensive gastropathy and mucosal hemorrhage (PHGMH) in rats.METHODS PHGMH was prepared by starvation in rats with liver cirrhosis and portal hypertention induced by abdominal injection of 30g/L thioacetamide. Morphological measurement and autoradiography were employed in PHGMH rats in two stages to observe the changes of the morphology in GMS and of the labelling index (LI) in GMECG.RESULTS ①The bleeding rate (912%) and severity (grade, 2.27±0.20) in PHGMH rats were more significant than that in control group (P<0.01). With the development of portal hypertension, the bleeding rate and severity increased significantly both in PHG-MHⅠ and in PHGMHⅡ rats (P<0.05 or P<0.01). ②DGMM and PSmVD were significantly increased both in PHG-MH (40.1μm±3.0μm, P<0.05; and 0.50±0.03,P<0.01) and in PHG-MHⅡ rats (43.8μm±4.20μm, P<0.05; and 0.564±0.042, P<0.01), but were not in PHGMHⅠ rats (P>0.05). Furthmore, PSmVD in PHGMHⅡ rats was significantly larger than that in PHG-MHⅠ rats (P<0.05). ③MLI(11.7%±1.0%) and BLI (106%±09%) were decreased obviously in PHG-MH rats (P<0.05,vs control). With the development of portal hypertension, MLI, BLI, BsLI and BbLI were all decreased significantly in PHG-MHⅡ rats (P<0.05 or P<0.01), but were not in PHG-MHⅠ rats, respectively. ④Submucosal thickness (SmT) in PHG-MH rats were increased markedly (P<0.01). ⑤There was a negative relation among LI, PSmVD, DGMM and SmT in PHGMH.CONCLUSION One of the bleeding mechanisms for ectasias and congestion in GMS is the lower status of cytokinetics in GMECG. It occurred mainly in a relative later stage of portal hypertensive gastropathy.