铝碳酸镁对十二指肠液反流所致大鼠食管病变的防治作用

The protective and curative effects of Hydrotalcid on various changes of esophageal mucosa in rat by duodenal reflux

目的 通过动物实验 ,研究十二指肠液反流对食管上皮的损伤及评价铝碳酸镁对食管粘黏损伤的预防和治疗作用。方法 16 0只SD大鼠 ,♂ ,2 0只为正常空白对照 (C组 ) ,14 0只行全胃切除 +食管空肠吻合术 ,术后 2周存活的大鼠随机分为A、B两组 ,A组予以铝碳酸镁管喂 ,B组管喂等量的生理盐水 ,术后 10周处死所有的大鼠 ,对食管上皮进行大体形态、病理学及电镜观察。结果 A、B两组的食管有程度不同的反流性食管炎 ,组织学表现为炎症、糜烂、溃疡、鳞状上皮增生、Barrett上皮化生及不典型增生。B组的炎症程度重于A组 (P <0 .0 1) ,Barrett上皮化生及不典型增生的发生率明显高于A组 (P <0 .0 5 )。B组有 1例食管微灶腺癌形成。扫描及透射电镜发现B组有Barrett化生的食管上皮典型分泌型肠上皮的特征。结论 铝碳酸镁能有效保护十二指肠液反流的食管粘黏 。

OBJECTIVE To characterize the effects of duodenal reflux on the histologic changes of esophageal mucosa in SD rats and to evaluate the preventive and curative effects of Hydrotalcid.METHODS 160 male SD rats were studied.20 unoperated rats served as controls (group C). The other rats underwent total gastrectomy and oesophagojejunostomy to produce duodenal reflux. Two weeks after sugery, the survivors were randomizedly divided into two groups (group A and B). Hydrotalcid was given for prevention to rats of group A, while equal saline was given to rats of group B. All survivors were sacrificed at 10 weeks post-operatively. The esophageal mucosa samples were studied by gross, microscopy and electron microscopy study.RESULTS Reflux esophagitis (RE) was found in the lower portion of the esophagus in both group A and B. Inflammation was more severe in group B than that in group A ( P <0.01).The incidence of column metaplasia and dysplasia in group B was significantly higher than that in group A ( P <0.05). One microinvasive lesion adenocarcinoma was found in group B. By scanning electron microscopy (SEM) and transmission electron microscopy (TEM), the distinct cells in esophageal mucosa with column metaplasia of group B had features of secretory intestinal mucosa.CONCLUSION Hydrotalcid was effective in both preventing and treating various pathologic injury of esophageal mucosa with duodenal reflux.