5%NaOH溶液与5%HCl溶液在兔腐蚀性食管炎性狭窄模型中的比较

Comparison of 5%NaOH and 5%HCl in a rabbit model of caustic esophageal stricture

目的比较5%NaOH溶液与5%HCl溶液在兔腐蚀性食管炎性狭窄模型建立后一般情况、HE染色及蛋白的表达。方法购置清洁级新西兰大白兔9只,雌雄不限,5月龄,体质量(2.5±0.5)kg,标号1~9,将实验动物随机均分为A、B、C组,每组3只。A组采用5%NaOH溶液造模,B组5%HCl溶液造模,C组采用0.9%生理盐水作为对照组。吸入麻醉成功后,采取双腔气囊法构建一个独立封闭的食管烧伤面积,分别向A、B、C组隔离部位注入5%NaOH溶液、5%HCl溶液及0.9%生理盐水(总量1.0 mL)并保持30 s后,A、B组用生理盐水冲洗多次。于造模后1 d、3 d、5 d、1周观察模型兔体质量、食物性状及吞咽困难情况,检测食管狭窄段HE染色及蛋白的表达情况[collagenⅠ、平滑肌肌动蛋白(a-smooth muscle actin,a-SMA)]。结果9只新西兰大白兔均造模成功。A组造模后1~9 d体质量逐渐减轻,后期体质量维持第9天重量,食物量减少,第6天后不能进食。B组体质量有减轻,食物性状以固体为主,第9天后不能进食;C组体质量正常,食物性状为固体,吞咽情况正常。(1)大体观:大体形态可见管腔缩窄,局部颜色加深。(2)HE染色:实验A组黏膜及黏膜下广泛坏死并破坏肌层结构,间质可见以嗜酸性粒细胞细胞、淋巴细胞为主的炎性细胞浸润,实验B组鳞状上皮结构完整,少许胶原纤维增生;实验C组鳞状上皮结构完整。(3)蛋白表达:实验A组见胶原纤维沉积及平滑肌肌动蛋白表达。结论5%NaOH溶液在兔腐蚀性食管炎性狭窄过程中,对兔食管三层结构均存在腐蚀作用,而5%HCl溶液仅伤及黏膜层,可能为食管的深层提供保护。

Objective To compare the general condition,HE staining and protein expression of 5%NaOH solution and 5%HCl solution in rabbit erosive esophagitis stricture model.Methods Nine New Zealand white rabbits of clean grade,male or female,aged 5 months,weighing(2.5±0.5)kg,labeled 1~9,were purchased and randomly divided into groups A,B and C,with 3 rabbits in each group.Group A was modeled with 5%NaOH solution,Group B with 5%HCl solution,and Group C with 0.9%physiological saline as the control group.After successful inhalation anesthesia,an independently closed esophageal burn area was constructed by double-lumen balloon method,and 5%NaOH solution,5%HCl solution,and 0.9%normal saline(total 1.0 mL)were injected into the isolated site of groups A,B,and C,respectively,and maintained for 30 seconds,then groups A and B were washed with normal saline several times.The body weight,food characteristics and dysphagia of the model rabbits were observed at 1 day,3 days,5 days and 1 week after model establishment,and HE staining and protein expression[collagenⅠ,smooth muscle actin(a-smooth muscle actin,a-SMA)]in the esophageal stricture segment were detected.Results Nine New Zealand white rabbits were successfully modeled.In group A,body weight gradually decreased 1~9 days after modeling,body weight maintained the weight on the 9th day in the later stage,food intake decreased,and food could not be eaten after the 6th day.In group B,body weight was reduced,food traits were mainly solid,and they could not eat after the 9th day.In group C,body weight was normal,food traits were solid,and swallowing was normal.(1)Gross view:gross morphology showed luminal narrowing and local color deepening.(2)HE staining:In group A,extensive necrosis and destruction of myometrial structure were observed in the mucosa and submucosa,and inflammatory cell infiltration mainly eosinophil cells and lymphocytes were observed in the stroma.In group B,the squamous epithelium structure was intact and a few collagen fibers proliferated.In group C,the squamous epithelium structure was intact.(3)Protein expression:Collagen fiber deposition and smooth muscle actin expression were observed in group A.Conclusion 5%NaOH solution has a corrosive effect on the three layers of esophageal structure in rabbits with corrosive esophagitis stricture,while 5%HCl solution only injures the mucosal layer,which may provide protection for the deep layer of esophagus.