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作 者:刘璞[1] 李济宇[1] 全志伟[1] 汪萍[1] 姚晓红[1] 沈美芬[1]
机构地区:[1]上海第二医科大学附属新华医院普外科,上海200092
出 处:《肝胆胰外科杂志》2006年第3期161-164,共4页Journal of Hepatopancreatobiliary Surgery
基 金:上海市自然科学基金资助项目(02EB14045)
摘 要:目的探讨正常实验大鼠经胆管灌注表柔比星后肝脏、胆管上皮和胰腺损伤的耐受情况,为经胆道灌注化疗治疗原发性胆管癌这一新辅助治疗手段奠定实验基础。方法选择正常SD大鼠为实验动物,采用开腹胆总管插管灌注表柔比星并保持一定的灌注时间,观察不同时段后的肝功能、血胰淀粉酶变化情况。同时观察胆管上皮细胞和胰腺的形态学变化,明确化疗药对肝脏、胰腺及胆管上皮的损伤,这种损伤又是否能可逆性的恢复,观察动物能否耐受。结果胆管灌注化疗可在短期内造成谷丙、谷草转氨酶的明显升高(P<0.01);虽然出现了胰腺组织中炎性细胞浸润的形态学变化,但血胰淀粉酶的变化在统计学上无显著性意义(P>0.05);胆管上皮微绒毛减少甚至消失,胆管上皮细胞坏死增多,但随着时间的延长,这种损伤可以得到部分的修复,甚至可以回到正常状态。结论经胆道灌注表柔比星会造成肝功能、胆管上皮短期的急性损害,但这种损害在短期内就能可逆性的修复,动物是能够耐受的。Objective To appraise the tolerance of liver, epithelium of bile duct and panereas afar transbiliary chemotherapeutic infusion in normal rats, and provide the basis for establishment of new adjuvant chemotherapeutic in cholangicearcinoma. Methods Normal SD rat was selected as an experimental animal. Transbiliary infusion was performed with explorative tansbiliary intubation. The chemicals sustained in bile duct for 30 minutes, then, the changes of liver function, hemodiastase, the pathologic appearance of pancreas and biliary epithelia were observed after different duration, to identify the degree of injury, and whethor it could be toleranted. Results Transbiliary chemotherpeulic infusion resulted in hepatocytes necrosis immediately, including severe increases of GPT, GOT; hemodiastase hadn't significant increased although somo inflammatory cells were found in panerereatic tissues. Microscope showed microvilli of epithelial cells in bile duct shortened or even disappeared, some necroses of epithelia in bile duct were also observed. But, all these damage appeerance relieved with time prolonging. Condusion Transbilinry chemotherpeutic infusion will induce trauma in liver epithelia in bile duct, but these trauma can be recovered in two weeks, the rats can be tolerant.
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