长期胆汁反流对大鼠胃黏膜的影响  

Effects of Chronic Bile Reflux on the Gastric Mucosa of Rats

作　　者：王学伟[1] 曹勤[1] 唐剑敏[1] 

机构地区：[1]上海中医药大学附属普陀医院消化内科病理科,上海200062

出　　处：《中国临床医学》2012年第5期470-472,共3页Chinese Journal of Clinical Medicine

基　　金：上海中医药大学附属普陀医院基金(编号:20075030A)

摘　　要：目的:建立模拟人体生理性胆汁反流的大鼠模型,观察长期胆汁反流对大鼠腺胃和前胃黏膜的影响。方法:13只Spra-gue-Dawley大鼠于十二指肠的胆总管开口下端截断,于大鼠前胃大弯侧行胃-空肠吻合,胆汁反流1年后,研究大鼠腺胃和前胃黏膜的病理特点,并采用免疫组化方法,研究胆汁反流对腺胃黏膜胃泌素表达的影响。结果:长期胆汁反流导致腺胃腺体显著增生、扩张,并出现异型增生和癌变,溃疡和肠化生相对少见;前胃鳞状上皮显著增生和角化,并出现角化珠和角化囊肿,肠化生相对少见,无溃疡和肿瘤发生。长期胆汁反流还可导致大鼠腺胃黏膜胃泌素表达显著增高。结论:长期胆汁反流可导致大鼠胃黏膜腺上皮和鳞状上皮显著增生,并发生异型增生和癌变,这可能与腺胃高胃泌素表达有关;肠化生和溃疡相对少见。Objective：To establish a rat model that could simulate the physiological bile reflux in human beings, and to study the pathological effects of chronic bile reflux on the mucosa of glandular stomach and forestomach in rats. Methods：The duodenum of 13 Sprague-Dawley rats were transected below the opening of the common bile duct, and gastrojejunostomy was performed at the greater curvature of the forestomach. After the rats showed bile reflux for 1 year, the pathological features of the glandular stomach and forestomach mucosa were studied. The effect of bile reflux on gastrin expression in the glandular sto mach mucosa was also studied by using immunohistochemistry. Results： Chronic bile reflux caused significant hyperplasia and expansion of gastric gland in the glandular stomach. Dysplasia and eanceration also developed, whereas ulcer and intestinal metaplasia were relatively rare. In the forestomach, the squamous epithelium showed significant hyperplasia and keratinization along with keratin pearls and keratocysts, while intestinal metaplasia was relatively rare, and no ulcers or tumorigenesis was observed. Chronic bile reflux significantly increased gastrin expression in the glandular stomach mueosa. Conclusion： Chronic bile reflux caused significant hyperplasia along with dysplasia and canceration of the glandular and squamous epithelium of the rat gastric mucosa, and that might be related to high gastrin expression in the glandular stomach. Intestinal metaplasia and ulcer were relatively rare.

关 键 词：胆汁反流 胆汁 腺癌 肠化生 胃泌素 

分 类 号：R573[医药卫生—消化系统]