梗阻性黄疸对肠黏膜通透性的影响

Influence of Obstructive Jaundice on Intestinal Mucosal Permeability

目前尚不能完全避免梗阻性黄疸患者并发症的发生,败血症和肾功能衰竭是主要原因。梗阻性黄疸患者出现并发症的主要病理生理学特点为小肠屏障功能破坏导致的肠源性内毒素血症。其破坏因素是多方面的,包括免疫屏障、生物屏障以及机械屏障的破坏。实验研究表明梗阻性黄疸时通常出现小肠黏膜通透性增加,主要影响因素有小肠肠壁细胞紧密连接蛋白表达改变、氧化应激反应、肠壁细胞增殖与凋亡失衡等。

Complications of obstructive jaundice still cannot be completely prevented at present,mainly due to sepsis and renal dysfunction.The key event in the pathophysiology of obstructive jaundice-associated complications is endotoxemia of gut origin because of intestinal barrier failure,which is multi-factorial,including disruption of the immunological,biological and mechanical barrier.Experimental studies have shown that obstructive jaundice results in increased permeability of intestinal mucosa.Here is to make a review on pivotal factors,such as altered intestinal tight junctions expression,oxidative stress and imbalance of enterocyte proliferation and apoptosis.