实验性梗阻性黄疸胆道损伤的超微结构研究

The Study of the Ultrastructural changes of the Bile Duct Injury in the Obstructive Jaundice Experimental

目的探讨可逆型梗阻性黄疸实验动物胆管损伤的组织学与超微结构变化。方法用止血钳钳夹胆总管造成实验兔可逆型梗阻性黄疸。梗阻后3~30d测定血清胆红素（TBIL、DBIL）和胆汁酸（BA）,并取胆管组织进行病理学检查;另取14d胆管组胆作电子显微镜观察。结果胆道梗阻7d,实验组TBIL、DBIL、BA分别为（31.1±16.9）μmol/L、（16.70±9.20）μmol/L和（61.5±24.5）μmol/L,显著高于对照组（5.9±1.5）μmol/L、（1.60±0.58）μmol/L和（21.1±13.5）μmol/L,差异有统计学意义（P〈0.01）;30d内,实验组逐渐升高。胆管病理组织学检查显示,胆道梗阻3~30d实验组均发生胆管损伤性炎症,造成胆管阻塞;30d时胆管损伤有所恢复。超微结构观察显示,胆道梗阻14d,胆管各层细胞胞核、细胞器均有明显损伤性改变。结论外力性可逆型梗阻性黄疸时胆管组织细胞病理学和超微结构改变明显。

Objective To study the histology and ultra-microscopic structural changes of reversible obstructive jaundice bile duct injury in animal model. Methods Reversible obstructive jaundice bile duct injury in experimental rabbits was created via clamping bile duct by astrictive clamps. From the third day to the 30 th day post biliary obstruction,the levels of serum bilirubin（ TBIL,DBIL） and bile acid（ BA） were detected and the pathological examination was made on the tissues of bile duct. Meanwhile,bile duct tissue specimens of bile duct were obtained on 14 th day post treatment and then observed under electronic microscope. Results On the 7th day post biliary obstruction,the TBIL、DBIL and BA experimental group were（ 31. 1±16. 9） μmol / L,（ 16. 70±9. 20） μmol/L and（ 61. 5±24. 5） μmol/L,which are significantly higher than those（ 5. 9±1. 5） μmol/L,（ 1. 60±0. 58）μmol /L and（ 21. 1±13. 5） μmol /L,（ P〈0. 01） in the control group. The TBIL、DBIL、BA levels of rabbits in the experimental group were elevated in 30 days. From the third day to the 30 th day post biliary obstruction,the pathohistological examination of bile duct showed that,experimental group injury-related bile duct inflammation and induced bile duct obstruction,and biliary obstruction was partially recovered in 30 th day. Ultra-microscopic structural changes results illustrate that on 14 th day after biliary obstruction,obviously damnification were found in nucleus and organelles of bile duct layers of cells. Conclusion External force induced reversible obstructive jaundice can cause obvious changes in Histopathological examinations and ultra-microscopic structure of bile duct.