梗阻性黄疸大鼠胆汁内、外引流术后血浆二胺氧化酶活性变化与肠粘膜屏障变化的相关性研究

目的:探讨梗阻性黄疸大鼠行胆汁内、外引流术后血浆二胺氧化酶的活性变化与肠粘膜屏障的关系。方法:取健康成年雄性SD大鼠60只,随机分为四组:梗阻性黄疸组(OJ)、胆汁外引流组(ED)、胆汁内引流组(ID)及假手术对照组(SH),各组均15只;SH组、OJ组在术后第7天处死大鼠并采集标本,ID组、ED组于引流术后7天处死大鼠并采集标本,检测各组大鼠血浆DAO的活性,光镜下观察末端回肠组织粘膜形态学变化。结果:OJ组大鼠肠粘膜损伤明显,粘膜变薄、绒毛稀疏、上皮完整性受到破坏并伴有炎性细胞浸润,ID、ED组大鼠肠粘膜有不同程度的恢复,ID组更接近SH组;OJ组血浆DAO水平显著升高,明显高于SH、ID、ED组(8.183±0.211 vs 3.570±0.280、3.978±0.269、5.051±0.328 U/L,P0.01),ID组较ED组下降更明显,二者差异有统计学意义(P0.01),ID组血浆DAO水平略高于SH组,二者差异无统计学意义(P0.05);各组血浆DAO变化与肠粘膜组织病理学变化一致。结论:胆汁内、外引流术可降低梗阻性黄疸大鼠血浆DAO水平,内引流术效果优于外引流术;血浆DAO的变化可反映梗黄大鼠肠粘膜屏障损伤及修复情况。

The Correlation Study of the Plasma Diamine Oxidase Activities and the Intestinal Barrier Function in Rats with Obstructive Jaundice after Internal and External Biliary Drainages*

Objective： To investigate the relationship between the plasma diamine oxidase（DAO） activities and the intestinal barr- ier function in rats with obstructive jaundice after internal and external biliary drainages. Methods： Sixty adult healthy male SD rats were randomly divided into four groups ：obstructive jaundice group（OJ） external drainage group（ED）, internal drainage group（ID） and shame operation group （SH）. There were 15 rats in each group. Specimens from the rats of SH and OJ groups were collected one week after the surgery. Different billiary drainages were performed in ID and ED groups, and the specimens were harvested seven days after the operation. The activities of the plasma DAO were determined and the morphological changes of the terminal ileum mucosa were observed under the light microscope. The results were compared between different groups. Results： The injures of the intestinal mucosa were obvious in OJ group with thin mucosa, sparse villous, destruction of the epithelial integrity and inflammation cell infiltration, while the situations of the intestinal mucosa in ED and ID groups recovered, and ID group was more similar to SH group in intestinal mucosal morphology. Compared with the other groups, the levels of the DAO in OJ group increased dramatically（8.183± 0.211 vs 3.570± 0.280, 3.978± 0.269, 5.051 ± 0.328 U/L, P〈0.01）, and the activities of the DAO in ID group, which were similar to the level of SH group（P〉0. 05）, decreased more significantly than that in ED group（P〈0.01）. The changes of the plasma DAO activities were significantly correlated with pathological examination of intestinal mucosa. Conclusions： These data suggest that both of the internal and external biliary drainages may reduce the plasma DAO activities in rats with obstructive jaundice but the internal biliary drainage is better, and the level of the plasma DAO can reflect the damage of the intestinal barrier function in obstructive jaundice rats.