兔胆囊切除术后Oddi括约肌离体收缩及肌球蛋白重链表达变化  

Change of motility in vitro and myosin heavy chain in sphincter of Oddi after cholecystectomy

作　　者：何谦[1] 李智华[1] 王铁虎[1] 熊燕[1] 刘永康[1] 张志波[1] 

机构地区：[1]第三军医大学西南医院全军肝胆外科研究所,重庆400038

出　　处：《第四军医大学学报》2009年第9期778-780,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金(30772109)

摘　　要：目的:探讨兔胆囊切除术后奥迪氏括约肌(SO)自身发生的适应性变化.方法:将60只成年新西兰大白兔随机分为4组,其中A,D组各18只;B,C组各12只.设A组为对照组,采用假手术方式,开腹暴露胆囊后即关闭腹腔,饲养8wk.B,C,D组为实验组,分别完整切除胆囊后饲养2,4,8wk.按设计的时间点饲养结束后将兔麻醉并取出SO,每组各取12只经离体测压后提取总蛋白通过Western Blot蛋白检测肌球蛋白重链(MHC)表达变化.另各取A,D组中剩余的6只大鼠的SO行石蜡切片免疫组化检测MHC表达变化.结果:与A组相比较,实验B,C,D组离体SO压力波幅和SO中的MHC表达均逐渐升高,差异具有统计学意义(P<0.01).免疫组化结果显示,D组相对于A组平滑肌细胞中的MHC浓染.结论:兔胆囊切除术后SO括约肌发生了适应性收缩能力增强,MHC表达上调变化,可能是胆囊切除术后患者SO括约肌功能障碍多发生障碍的病理基础之一.AIM： To study the alteration of rabbits＇ sphincter of Oddi after cholecystectomy. METHODS： Sixty adult rabbits were divided into 4 groups（A, B, C and D）, with 18 rabbits in A and D, and 12 rabbits in C and D. In the post cholecystectomy groups （B, C and D）, the rabbits underwent cholecystectomy and then were bred for 2, 4 and 8 weeks respectively, while the rabbits in the control group （A of sham operation） were bred for 8 weeks. Then, the rabbits＇ sphincters of Oddi were dislodged. Six rabbits of A and D groups were detected by myosin heavy chain （MHC） immunohistochemistry, 12 rabbits of the 4 groups were measured by manometer in vitro and MHC expression was examined by western blot. RESULTS： Amplitude of manometer wave increased significantly but not in A group （ P 〈 0.01 ） and MHC expression in SO of B, C, D groups significantly increased compared with that of A group （ P 〈 0. 01 ）. Immunohistochemistry showed that smooth muscle cells of D group were more concentrated than those in A group in the dye of myosin. CONCLUSION ： SO is adaptively changed after cholecystectomy, which may be one of the etiopathogenisis for many clinical problems concerning sphinter of Oddi disfunction in postcholecystectomy patients.

关 键 词：胆囊切除术后 ODDI括约肌 离体测压 肌球蛋白重链 

分 类 号：R657.4[医药卫生—外科学]