胆道局部抗生素冲洗治疗慢性增生性胆管炎的大白兔研究

Rabbit models for the study of local antibiotics irrigation on chronic proliferative cholangitis

目的探讨胆道局部抗生素冲洗治疗慢性增生性胆管炎(chronic proliferative cholangitis,CPC)的疗效。方法建立大白兔CPC模型,随机分为CPC组20只(胆管不冲洗氧氟沙星)和实验组20只(胆管内冲洗0.5%氧氟沙星)。仅切除胆囊,游离胆总管(假手术)大白兔20只设为正常组。对正常组、CPC组和实验组胆管组织内炎症情况、胆管细胞增生及胆管纤维化程度、胆管结石形成能力进行对比分析。结果实验组与CPC组相比,胆管组织中炎症指标脂多糖和白介素-6[(1.21±0.13)比(3.24±0.21),(1.52±0.22)比(3.10±0.23)]、胆管细胞增生指标环加氧酶-2和血管内皮生长因子[(2.15±0.12)比(4.07±0.22),(2.44±0.14)比(3.22±0.21)]、纤维化指标转化生长因子-β和胶原1[(2.44±0.28)比(4.36±0.44),(1.54±0.13)比(2.22±0.18)]及结石形成指标β-葡萄糖醛酸酶和粘蛋白5AC[(1.74±0.20)比(3.42±0.31),(1.47±0.15)比(2.81±0.22)]相对表达均明显下调,差异均具有统计学意义(均P<0.05)。结论胆道局部持续冲洗抗生素可有效缓解胆道慢性炎症,抑制胆管细胞的过度增殖和胆管纤维化,并降低结石形成能力,进而发挥控制CPC的作用。

Objective To investigate the effect of local antibiotics irrigation on chronic proliferative cholangitis(CPC).Methods CPC model of rabbits was established.Rabbits were divided into CPC group(without local antibiotics irrigation,n=20)and experimental group(with local antibiotics irrigation,n=20).Only the gallbladder was removed,and 20 rabbits with free bile duct(sham operation)were used as normal control.The inflammatory conditions,proliferation of cholangiocytes,biliary fibrosis and biliary stones formation ability were analyzed.Results Compared with CPC group,the relative expression of inflammation index lipopolysaccharide and interleukin-6[(1.21±0.13)vs.(3.24±0.21),(1.52±0.22)vs.(3.10±0.23)],biliary cell proliferation index cyclooxygenase-2 and vascular endothelial growth factor[(2.15±0.12)vs.(4.07±0.22),(2.44±0.14)vs.(3.22±0.21)],fibrosis index transforming growth factor-β and Collagen-I[(2.44±0.28)vs.(4.36±0.44),(1.54±0.13)vs.(2.22±0.18)]and biliary stones formation index β-glucuronidase and Mucin 5AC[(1.74±0.20)vs.(3.42±0.31),(1.47±0.15)vs.(2.81±0.22)]were significantly decreased in experimental group(all P<0.05).Conclusion Local antibiotics irrigation could inhibit CPC by inhibiting the chronic inflammation of the biliary tract and excessive proliferation of cholangiocytes and biliary fibrosis,and reducing the probability of biliary stone formation.