不同胆道引流方式对梗阻性黄疸大鼠肠屏障功能的影响

Effect of different biliary drainage methods on intestinal barrier function in rats with obstructive jaundice

目的:探讨不同胆道引流方式对梗阻性黄疸大鼠肠屏障功能的影响.方法:60只SD大鼠随机分为假手术组(shame operation,SO组)、梗阻性黄疸组(obstructive jaundice,OJ组)、内引流组(internal biliary drainage,ID组)和外引流组(enternal biliary drainage,ED组).制备OJ模型,SO组、OJ组在术后第7天处死大鼠并采集标本,ID组、ED组则行不同引流手术,在引流术后第7天处死大鼠并采集标本.检测血清丙氨酸氨基转移酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、胆汁酸(totalbileacide,TBA)及小肠黏液sIgA含量,并对结果进行统计学分析.结果:OJ组较SO组血清ALT、TBIL、DBIL、TBA均明显升高,小肠黏液sIgA含量(0.160±0.150)明显减少.ED、ID组血清中ALT、TBIL、DBIL、TBA明显低于OJ组;ID组小肠黏液sIgA含量明显高于OJ组及ED组(0.272±0.182vs0.160±0.150,0.191±0.113,均P<0.05).结论:胆道内、外引流均能有效解除胆道梗阻,改善肝功能.但内引流可明显增加肠道黏液sIgA,其改善肠道屏障功能的效果优于外引流.

AIM： To investigate the effect of different biliary drainage methods on intestinal barrier function in rats with obstructive jaundice. METHODS： Sixty healthy SD rats were divided into four groups： sham-operation （SO） group, obstructive jaundice （OJ） group, internal drain- age （ID） group, and external drainage （ED） group. One week after surgery, specimens from the rats of the SO and OJ groups were collected. Biliary drainage was performed using different methods in the ID and ED groups, and the speci- mens were harvested seven days after drainage. The levels of alanine aminotransferase （ALT）, total bilirubin （TBIL）, direct bilirubin （DBIL）, and total bile acide （TBA） in serum, and slgA in intestine mucus were determined and compared between different groups. RESULTS： Serum levels of ALT, TBIL, DBIL,and TBA were significantly higher in the OJ group than in the SO, ID, and ED groups. The levels of sIgA in intestine mucus were signifi- cantly higher in the ID group than in the OJ and ED groups （0.272 ＋ 0.182 vs 0.160 ＋ 0.150, 0.191 ＋ 0.113, both P 〈 0.05）. CONCLUSION： Both ID and ED effectively re- lieve biliary obstruction and improve liver func- tion. ID significantly increases intestinal mucus sIgA. The effect of ID on intestinal barrier func- tion is better than that of ED.