急性胆道梗阻肝脏损伤的实验研究

Experimental study of liver injury secondary to acute bile duct obstruction

目的：探讨大鼠急性胆道梗阻后肝脏损伤的变化。方法：雄性Wistar大鼠，随机分为实验组（胆总管结扎）和对照组（假手术），观察术后不同时间点动物的一般情况、黄疸、生化指标和肝脏病理学变化。结果：对照组术后各项观察指标均无明显异常。实验组术后出现体质量降低、活动减少和明显的黄疸，但3d后均有所改善；术后血清总胆红素（TBIL）和直接胆红素（DBlL）水平明显升高，3d达到高峰，之后缓慢降低；术后谷丙转氨酶（ALT）迅速增加，1-2d达到高峰，3d后迅速下降；碱性磷酸酶（ALP）于术后2d达到高峰，3d后逐渐下降；术后肝组织Metavir评分逐渐增加，3d时开始出现明显胶原纤维增生。结论：肝脏急性损伤期在急性胆道梗阻后1周内期间2-3d进展达高峰，并出现纤维化。

Objective： To monitor the state of liver injury after acute biliary obstruction in rats. Methods： Male Wistar rats were randomly divided into experimental group （common bile duct ligation）and control group （sham operation）. At defined time points after surgery, the general status, jaundice, and biochemical parameters variations as well as the liver pathological changes of the animals were assessed. Results： In control group, all the observation parameters had no obvious abnormalities after surgery. In experimental group, the animals showed reduced body weight gain, decreased motor activity and overt jaundice, but all tended to improve after the third postoperative day; the total bilirubin （TBIL） and directbilirubin （DBIL） levels increased significantly after surgery, peaked on the third day and then gradually decreased; the level of aspartate aminotransferase （AST） increased rapidly after surger）5 reached a peak on thefirst and second postoperative day, and dropped rapidly after the third postoperative day; the level of alanine aminotransferase （ALT） attained a peak on the second postoperative day and declined gradually from the thirdpostoperative day; the Metavir scores of the rats＇ liver tissues increased progressively during the course of the experiment, and there was clear collagen fiber hyperplasia from the third operative day. Conclusion： The acute stage of liver injury secondary to acute biliary obstruction is within the first week following onset, during which time the liver injury reaches a climax on the second and third day, and hepatic fibrosis also develops.