腹膜透析液对小鼠腹膜间皮超微结构的影响  

Effect of Dialysates on Ultrastructure of Mouse Peritoneal Mesothelium

作　　者：李继承[1,2] 钟海玲[1,2] 张凯[1,2] 陈一芳[1,2] 徐萍[1,2] 丁伟勇[1,2] 

机构地区：[1]浙江大学医学院淋巴学研究室 [2]杭州市红十字会医院

出　　处：《中国医学科学院学报》1999年第3期208-213,共6页Acta Academiae Medicinae Sinicae

基　　金：浙江省分析测试基金

摘　　要：目的应用美国Ｂａｘｔｅｒ腹膜透析液和国产乳酸盐、醋酸盐腹膜透析液进行持续性不卧床腹膜透析动物实验，以观察和比较不同类型透析液对正常小鼠腹膜间皮的损伤作用。方法分别将３种透析液注入各组小鼠腹膜腔内，在透析第１０天、第２１天和停药后第１０天取膈腹膜，作电镜观察。结果注入透析液后第１０天，乳酸盐组和醋酸盐组腹膜间皮发生病理变化并随着透析时间延长而进行性加重，出现微绒毛脱落和粘连、间皮细胞皱缩和纤维蛋白性粘连。Ｂａｘｔｅｒ组间皮细胞的病理变化表现轻微。注入透析液后第２１天，乳酸盐组和醋酸盐组的腹膜淋巴孔直径分别为（６．９６±２．４６）和（６．９８±２．１６）μｍ，明显大于对照组（１．４７±０．８８）μｍ（Ｐ＜０．０１）；淋巴孔的分布密度与对照组比较差异亦有显著性（Ｐ＜０．０１），而Ｂａｘｔｅｒ组的淋巴孔直径及分布密度均无明显变化。停止注射透析液后第１０天，Ｂａｘｔｅｒ组间皮细胞恢复正常；乳酸盐组和醋酸盐组均有不同程度恢复，但淋巴孔仍呈病理改变。结论乳酸盐和醋酸盐腹膜透析液易引起腹膜间皮细胞纤维化，导致硬化性腹膜炎的发生。Objective To observe the effect of various peritoneal dialysates on the ultrastructure of the peritoneal mesothelium. Methods Continuous ambulatory peritoneal dialysis mice model was made by injecting domestic lactate, acetate, and American Baxter dialysates intraperitoneally. The diaphragmatic peritoneum of the mice was taken at 10th day and 21th day respectively after injection. Results After 10 day experiment, the mesothelial ultrastructure of Baxter group was normal, but some pathological changes occurred in the peritoneal mesothelium of both domestic lactate and acetate groups. And the injury of the peritoneal mesothelium was progressing with times, e. g. adhesion and exfoliation of the microvilli, shrinkage of the mesothelial cells and even fibrous adhesion. The extent of effects on the mesothelial cells varied in three groups, the least is Baxter group. After 21 day experiments, the diameters of the stomata were (6.96±2.46) μm and (6.98±2.16) μm in both domestic lactate and acetate dialysates groups respectively, which were much greater than those in physiological condition (1.47±0.88) μm ( P <0.01). The distribution density of the lymphatic stomata were significantly increased in acetate and lactate dialysate groups compared with the control group ( P <0.01). But little effects on the lymphatic stomata were showed after using Baxter dialysate. After discontinuing experiment for 10 days, the impairment of the peritoneal mesothelium recovered in Baxter group and improved to varying degrees in both domestic dialysate groups. The lymphatic stomata were still abnormal in both domestic dialysate groups. Conclusions Our findings indicate that lactate and acetate dialysates are more like to elicit peritoneal fibrosis and the increase of distribution density and the enlargement of t

关 键 词：腹膜透析 腹膜淋巴孔 间皮细胞 超微结构 

分 类 号：R459.5[医药卫生—治疗学]