胆汁反流致慢性萎缩性胃炎的实验研究

Experimental Study on Chronic Atrophic Gastritis Induced by Bile Reflux

通过施行大鼠胃空肠吻合术加十二指肠横断 ,建立胆汁反流致慢性萎缩性胃炎动物模型 ,观察胆汁反流引起的胃粘膜萎缩并初步分析其损伤机制。结果 :与对照组比较 ,手术后 14、2 0周组大鼠胃粘膜出现萎缩性改变 ,病理形态学积分显著增高 ;胃液 pH和总胆汁酸、血清胃泌素均有明显升高 ,胃粘膜PGE2 明显降低。说明长期胆汁反流可引起胃粘膜萎缩性改变 ,其早期萎缩改变的原因与胆汁反流减少粘膜保护因子PGE2 ,损伤胃粘膜防御机能 ,以及引起胃肠内分泌激素的失调有关。

Gastric mucosal atrophy caused by bile reflux was observed and its pathogenesis was analysed in the model of chronic atrophic gastitis induced by bile reflux. The model was established by performing Gastrojejunostomy and duodenum transsection on rats. The results showed that compared with the control group, there appeared gastric mucosal atrophic changes after 14 and 20 weeks with elevated histopathologic accumulative scores ( P <0.01), an increase in gastric juice pH value and in the levels of total bile acid and serum gastrin ( P <0.01), and a decrease in the level of gastric mucosal PGE 2 ( P <0.01, P <0.05) in the animals in the model group. The results imply that long term bile refux may cause gastric mucosal atrophic changes, and the gastric mucosal atrophic changes at its early stage may be related with the impairment of gastric mucosal defensive mechanism due to the decrease in the level of PGE 2 and the disorder of gastrointestinal endocrine hormones caused by bile reflux.