肝动脉栓塞致胃粘膜损伤的实验研究

Experimental study on gastric mucosal injury by hepatic arterial embolization in rabbits

目的研究肝动脉栓塞致胃粘膜损伤的机制．方法日本大耳白兔３２只，随机分为３组：正常组８只，假手术对照组８只，肝动脉栓塞组１６只．用超液态碘油制兔部分肝动脉栓塞模型．在手术前后，用放免法测定其血浆中内皮素（ＥＴ）水平，直接穿刺门静脉测压，激光多谱勒血流仪测定其胃粘膜血流量（以电压Ｖ表示），并观察胃粘膜组织形态学改变．结果肝动脉栓塞术后３ｄ和６ｄ兔血浆ＥＴ（ｎｇ／Ｌ，２１５±３５，２１５±４７）显著高于假手术对照组（１５５±２８，１４６±２８，Ｐ＜００１）．肝动脉栓塞术后６ｄ，其门静脉压力（ｋＰａ，１０９±０１０）明显高于对照组（０８５±００７，Ｐ＜００５）．胃粘膜血流量（３６４Ｖ±０７７Ｖ）显著低于正常组（４８１Ｖ±０４２Ｖ，Ｐ＜００５）和假手术对照组（４６５Ｖ±０３２Ｖ，Ｐ＜００５）．胃粘膜损害发生率（６８８％）显著高于对照组（２５０％，Ｐ＜００５）．结论肝动脉栓塞可使其血浆ＥＴ水平明显升高，门静脉压力增加，胃粘膜血流量下降。

AIM To investigate the mechanism of gastric mucosal injury by hepatic arterial embolization (HAE) in rabbits. METHODS The 32 rabbits were randomly divided into three groups: normal group (NG) 8, shamoperation group (SG) 8 and HAE group (HAEG) 16. Animal models of HAE were made with lipiodol ultra fluid. Before and after operation, the plasma endothelin (ET) was measured by radioimmunoassay. The portal pressure was determined directly. The gastric mucosal blood flow (GMBF) was measured by laser Doppler flowmeter as electric pressure Ⅴ. The changes of gastric mucosa were evaluated histopathologically. RESULTS On the third and sixth day after operation, plasma ET levels (ng/L) of HAE group were significantly higher than those in shamoperation group (HAEG: 215±35,215±47; PG:155±28,146±28, P <0 01). On the sixth day after operation, the portal pressure (kPa) increased remarkably in HAE group (HAEG: 1 09±0 10; PG:0 85±0 07, P <0 05), and the GMBF decreased significantly in HAE group (HAEG: 3 64V±0 77V; PG:4 65V±0 32V, P <0 05). The incidence of gastric mucosal injury was higher in HAE group (68 8%) than that in shamoperation group (25 0%, P <0 05). CONCLUSION HAE can cause remarkable damage of gastric mucosa in rabbits by elevating ET level, increasing portal pressure and decreasing GMBF.