转化生长因子β1在胆管吻合口狭窄病理过程中的作用  

Study on the Effect of TGF-β1 on Biliary Anastomatic Stricture

作　　者：周文华[1] 陈江[2] 章勇[2] 顾超[2] 周联明[1] 黄忠明[1] 张学利[1] 

机构地区：[1]南方医科大学附属奉贤医院普外科,上海201400 [2]复旦大学附属金山医院普外科,上海200540

出　　处：《中国临床医学》2010年第3期326-327,共2页Chinese Journal of Clinical Medicine

基　　金：上海市卫生局科研基金资助项目(编号:034101)

摘　　要：目的:研究在损伤性胆管狭窄病理过程中转化生长因子β1(TGF-β1)的作用。方法:实验用斑马猪24只,随机分成3组。空白对照组(C组)仅游离胆管20mm,以缝合针扎孔1周。手术对照组(S组)游离胆管20mm,切除约5mm,行端端吻合,T型管引流。手术治疗组(T组)依S组方式手术,并经Oddi′s括约肌置Forley导尿管(8号)至吻合口上15mm引流胆汁并支撑,气囊注水阻断胆汁流经吻合口以减轻瘢痕增生。术后12周取标本,HE染色分析术部瘢痕增生、吻合口内径与其近端10mm胆管内径比值,免疫组化法分析各组TGF-β1表达情况。结果:S组及T组处理部位均有瘢痕增生,吻合口管壁厚度分别为1.7±0.2mm和1.0±0.3mm,差异有统计学意义(P<0.05)。T组及S组吻合口内径较C组均有所减小,两组吻合口内径与其近端胆管内径比值分别为0.89±0.15和0.68±0.17,差异均有统计学意义(P<0.05)。C组仅有少量TGF-β1表达,10个高倍视野平均阳性细胞数为13,T组表达有所增加,高倍视野阳性数为16,但差异均无统计学意义(P>0.05),而S组的表达增加较明显,高倍视野阳性数为37,较前两组的差异均有统计学意义(P<0.05)。结论:TGF-β1参与胆管吻合口瘢痕增生狭窄病理过程,其表达随狭窄严重而增加,但其与吻合口瘢痕增生狭窄的因果关系有待进一步研究。Objective：To explore the effect of TGF-β1 on pathologic procedure of biliary anastomotic stricture.Methods： Twemtu-four experimental Bama mini-pigs were randomly divided into three groups： the sham operation control group（Group C）,we stabbed（not actually anastomosed） the bile duct by anastomotic needle after dissecting the bile duct;The operation control group（Group S）,we excised the bile duct 5mm in length after dissecting the bile duct and treated by end-to-end anastomosis;The treatment group（Group T）,we treated in the same way as the Group C and drained the bile by inserting a Forley urethral catheter in the bile duct above the anastomotic stoma 15mm,then infused water into the air chamber（the amount was determined by the diameter of the bile duct） to block the bile flow passing the anastomotic stoma.Then we analyzed the degree of hyperplasia in each group,the ratio of the diameter of the anastomotic stoma to the bile duct above,and the expression of TGF-β1 by immunohistochemistry method.Results： There were anastomotic stoma hyperplasia and decrease in diameter in Group C,Group S and GroupT,the lenghth of the wall of the bile duct were 0.9±0.2mm,1.7±0.2mm and 1.0±0.3mm,respectively.When compared Group T with Group C,the result was not statistically significant（P0.05）.When compared Group S with Group T and Group C,the results were statistically significant（P0.05）.The ratio of the diameter of Group C,Group T and Group S was 0.96±0.13,0.89±0.15 and 0.68±0.17,respectively.When compared Group S with Group C and Group T,the results were statistically significant（P0.05）.There were expression of TGF-β1 differently in GroupC,Group S and GroupT,the positive expression cells was 13,37 and 16 respectively.When compared Group S with Group C and Group T the results were statistically significant（P0.05）.Conclusions： TGF-β1 takes part in pathologic procedure of biliary anastomotic stricture.Its expression degree follows biliary anastomatic stricture.But what role it play

关 键 词：胆管吻合口 狭窄 转化生长因子Β1 

分 类 号：R657.4[医药卫生—外科学]