不同断流术式对门静脉高压症犬胃黏膜细胞凋亡的影响  

Effect of different portal-azygos devascularization procedures on apoptosis of gastric mucosal cells in portal hypertension canines with cirrhosis

作　　者：陈钟[1] 戴向华[1] 明志祥[1] 朱李瑢[1] 

机构地区：[1]南通大学附属医院普外科,226001

出　　处：《中华实验外科杂志》2009年第6期744-746,F0003-F0004,共5页Chinese Journal of Experimental Surgery

基　　金：南通市社会发展基金资助项目（S5044）

摘　　要：目的检测对不同断流术式前后门静脉高压症犬胃黏膜细胞凋亡，观察其对门脉高压性胃病（PHG）影响。方法将肝硬化门静脉高压症模型犬24条，随机分为A组（传统断流组）、B组（选择性断流组）、C组（吻合器断流组）及D组（对照组），每组6条。分别于术中及术后6个月测自由门静脉压（FPP），取胃组织，采用原位末端脱氧核苷标记法（TUNEL）染色测凋亡指数（AI）及Caspase-3蛋白免疫组织化学染色计算各染色强度细胞评分总和（H值）。结果术后6个月内，A、B、C组FPP均明显下降，其中以B组下降最为明显，其次为C组，最后为A组。术后6个月，A组AI值由术前的（14．68±1．28）％增至（20．22±2．20）％（P〈0．05），H值由术前的56．13±11．75增至113．78±19．80（P〈0．05）；B组AI值由术前的（13．63±1．19）％降至（9．98±2．29）％（P〈0．05），H值由术前的59．134±10．07降至22．354±4．75（P〈0．05）。C、D组术后6个月与术前比较，AI和H值无明显变化（P〉0．05）。结论肝硬化门静脉高压症犬行传统断流术术后胃黏膜细胞凋亡加重，PHG病变程度加剧；选择性断流术后胃黏膜细胞凋亡减轻，PHG病变程度改善；吻合器断流术后胃黏膜细胞凋亡变化无差异，对PHG病变影响不大。Objective To detect apoptosis of gastric mucosal cells in portal hypertension canines with cirrhosis after different portal-azygos devascularization procedures and investigate their effects on portal hypertension gastropathy （PHG）. Methods Portal hypertension was induced in canines by subcutaneous injection of 60% CCl4 emulsion and diet control. Twenty-four portal hypertension model canines were randomly divided 4 groups：group A （traditional paraesophagogastric devascularization group）, group B （selective paraesophagogastric devascularization group）, group C （selective paraesophagogastric devascu larization plus distal esophageal transaction and reanastomosis with stapler group）, and group D （control group, sham operation）. The changes in free portal pressure （FPP） and apoptosis of gastric mucosa cells were observed during operation and 6 months after operation. Apoptosis index （AI） was measured by TUNEL,and the expression of Caspase-3 was detected by immunohistotchemistry. Results FPP in groups A,B and C were decreased significantly post-operation and at the 6th month post-operation as compared with pre-operation （ P 〈 0.05 ）. FPP in group A （2.05 ±0. 07 ） kPa was significantly higher than that in groups B （1.28±0.05） kPa and C （1.41±0.04） kPa （P〈0.05） ,and that in group C higher than in group B （P 〈 0.05 ）. At the 6th month post-operation, AI was increased significantly from （ 14.68 ± 1.28） % to （ 20.22± 2.20 ） % （ P 〈 0.05 ）, and the expression of Caspase-3 was also increased from 56.13 ± 11.75 to 113.78 ±19.80 （P 〈 0.05）. In group B, AI was decreased from （ 13.63± 1.19 ） % to （9.98 ±2.29）% （P 〈0.05） ,and in group A the expression of Caspase-3 was decreased from 59.13 ± 10.07 to 22.35 ±4.75 （P 〈0.05）. In groups C and D,AI and the expression of Caspase-3 had no significant difference before and 6 six months post-operation （ P 〉 0.05 ）. Conclusion In portal hypertension canines with cirrhosis,the

关 键 词：门静脉高压症 断流术 吻合器 脱噬作用 犬 

分 类 号：R686[医药卫生—骨科学]