胰胆管合流异常胆道损伤抗氧化治疗的实验研究  

Experiment Study of The Anti-Oxidative Treatment in Biliary Tract with Pancreaticobiliary Maljunction

作　　者：陈风[1] 汤琳[2] 汪健[3] 黄顺根[3] 王兴东[3] 

机构地区：[1]上海第六人民医院普外科,上海200233 [2]南京中医药大学基础医学院,江苏南京210046 [3]苏州大学附属儿童医院普外科,江苏苏州215003

出　　处：《中国普外基础与临床杂志》2012年第10期1069-1073,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：南京中医药大学青年自然科学基金(项目编号:09XZR03);江苏省135工程重点人才项目(项目编号:2003098)~~

摘　　要：目的研究胰胆管合流异常(PBM)胆道损伤的抗氧化治疗的效果。方法选取13只健康杂种猫,建立PBM动物模型后随机分为2组:7只不进行抗氧化治疗(非抗氧化治疗组),6只行抗氧化治疗(抗氧化治疗组);以动物建模术前情况作为对照。建模术后饲养6个月观察胆囊组织的病理学改变,检测过氧化产物丙二醛(maleic dialdehyde,MDA)的变化情况、PCNA的表达情况以及胆汁淀粉酶水平。结果 13只动物建模后均存活6个月。非抗氧化治疗组较正常对照组胆管增粗,胆囊壁增厚,胆囊内胆汁稠厚;抗氧化治疗组和非抗氧化治疗组相比上述改变无明显不同。光镜下见正常对照组的胆囊黏膜呈指状,黏膜数目少,无增生;非抗氧化治疗组的胆囊黏膜增生及炎性细胞浸润,部分纤维组织增生。电镜下见正常对照组的胆囊黏膜上皮细胞排列紧密、规则;非抗氧化治疗组胆囊黏膜上皮细胞的内质网扩张成囊状,细胞间隙增宽,细胞核变形;抗氧化治疗组的上述改变较非抗氧化治疗组好转。胆汁淀粉酶正常对照组为(203.02±65.04)U,非抗氧化治疗组为(9 368.09±2 204.42)U,抗氧化治疗组为(8 746.25±2 077.95)U,后2组高于正常对照组(P=0.003),但后2组间比较差异无统计学意义(P=0.642)。PCNA表达阳性细胞所占百分比正常对照组为(7.29±2.71)%,非抗氧化治疗组为(54.71±10.90)%,抗氧化治疗组为(48.17±13.06)%,3组间相比差异有统计学意义(F=48.11,P=0.001),其中非抗氧化治疗组高于抗氧化治疗组(P=0.001)。MDA正常对照组为(1.095±0.653)nmol/mg prot,非抗氧化治疗组为(2.745±1.533)nmol/mg prot,抗氧化治疗组为(1.302±0.771)nmol/mg prot,3组间相比差异有统计学意义(F=5.17,P=0.017),其中非抗氧化治疗组高于抗氧化治疗组(P=0.017)。结论抗氧化治疗对PBM有效。Objective To evaluate the efficacy of anti-oxidative treatment in cats with pancreaticobiliary maljunction.Methods Thirteen healthy cats as control group were made a model that resembling the common channel of pancreaticobiliary maljunction as in humans,and were divided randomly into two groups：7 cats in untreated group were not treated,6 cats in anti-oxidative group were treated with melatonin,vitamin C,and vitamin E.Six months later,the gallbladders of these animals were removed and histopathological changes were evaluated by pathological and electron microscopic examination.The level of MDA,amylase concentration in the gallbladder bile,and percentage of proliferating cell nuclear antigen（PNCA） positive cells were also test.Results All cats had survived for 6 months after operation.The wall of gallbladder and the bile became thicker in untreated group than that in normal control group,and there were no significant differences between untreated group and anti-oxidative group.The gallbladder epithelium became villous in appearance in untreated group,although the epithelium of that in normal control group was flat with few folds.The epithelial cells of gallbladder arranged tightly in normal control group,while a significant change such as endoplasmic reticulum expanding,intercellular space broadening,and cellular nucleus deforming were observed in untreated group.The things in anti-oxidative group were better than untreated group.The amylase concentration in the gallbladder bile was（203.02±65.04）U in normal control group,（9 368.09±2 204.42） U in untreated group,and（8 746.25±2 077.95） U in anti-oxidative group,respectively.The amylase concentration in untreated group and anti-oxidative group were higher than that in normal control group（P=0.003）,and there was no significant difference between the untreated group and anti-oxidative group（P=0.642）.The percentage of PNCA positive cells was（7.29±2.70）% in normal control group,（54.71±10.90）% in untreated group,and（48.17±13.06）

关 键 词：胰胆管合流异常 胆道损伤 动物模型 抗氧化 褪黑素 

分 类 号：R657.4[医药卫生—外科学]