三种术式大鼠肝外型胆汁淤积模型的对比研究
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1.昆明医科大学,昆明 650500; 2.云南省第一人民医院 PET-CT 中心,昆明 650100; 3.云南省第一人民医院病理科,昆明 650100

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R-33

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Comparison of three surgical models of extrahepatic cholestasis in rats
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1.Kunming Medical University, Kunming 650500, China. 2. PET-CT Center, First People’s Hospital of Yunnan Province, Kunming 650100. 3. Department of Pathology, First People’s Hospital of Yunnan Province, Kunming 650100

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    摘要:

    目的 利用血清学、影像学及病理学评价 3 种术式大鼠肝外型胆汁淤积模型造模方式的优缺点。 方法 将 15 只雌性 SD 大鼠随机分为传统组、改良组及电刀组,分别采用胆总管结扎法( n= 5) 、肝门区肝总管缝扎法( n= 5)及胆总管高频电刀电凝法( n= 5)进行胆汁淤积手术造模,术前及术后进行 CT 平扫及体重测量,比较肝密度、胆管直径;术后 7 d 3 组大鼠进行采血,测量谷草转氨酶(AST) 、谷丙转氨酶(ALT) 、总胆红素(TBIL) 、直接胆红素(DBIL) ;采血结束后麻醉过量法处死大鼠,取部分肝组织使用 4. 2% ~ 5. 2%福尔马林溶液固定,石蜡切 片 HE 染色观察病理学变化。 结果 3 组大鼠造模后 7 d 均出现不同程度的肝损伤及胆汁淤积。 传统组较电刀 组 AST、TBIL、DBIL 高(P<0. 05) ,传统组较改良组 AST、ALT、TBIL、DBIL 高(P<0. 05) ;传统组及电刀组 ALT、改良组及电刀组 AST、ALT、TBIL、DBIL 之间比较均无统计学差异( P> 0. 05) ;病理学可见传统组在三组中胆管增生、胆管壁增厚程度最严重,改良组程度最轻,电刀组居于两者之间;CT 扫描传统组扩张肝外胆管内径大于改良组和电刀组(P<0. 05) ,改良组及电刀组两组之间胆管直径无统计学差异(P>0. 05) ;传统组肝 CT 值与术前比较 明显减低(P<0. 01) ,改良组和电刀组肝 CT 值较术前均无统计学差异(P>0. 05) 。 结论 电刀法及改良法均较有效的延长大鼠胆汁淤积的病程,可以更好的模拟人部分肝外胆汁淤积类疾病,为动态观察胆汁淤积病理过程提供了可能。

    Abstract:

    Objective To evaluate the advantages and disadvantages of three surgical models of extrahepatic cholestasis in rats using serological, imaging, and pathological examinations. Methods Fifteen female Sprague Dawley rats were randomly divided into traditional, modified, and electrocoagulation groups. The surgical models were bile duct ligation (n= 5) (BDL), modified hepatic duct ligation (HDL) ( n= 5), and choledochal electrocoagulation (CE) ( n= 5), respectively. Preoperative and postoperative computerized tomography (CT) scans were performed to compare changes in liver density and bile duct diameter. Blood samples were collected 7 d after surgery, and aspartate aminotransferase(AST), alanine aminotransferase ( ALT), total bilirubin ( TBIL), and direct bilirubin ( DBIL) were measured using enzyme-linked immunosorbent assay. All rats were sacrificed using excessive anesthesia after blood collection, part of the liver was collected and fixed with 4% formalin solution, and pathological changes observed using paraffin section hematoxylin and eosin staining. Results Different degrees of liver injury and cholestasis were observed 7 d after surgery in all three groups. AST, TBIL, and DBIL were higher in the BDL group than in the CE group (P<0. 05). AST, ALT, TBIL, and DBIL were higher in the BDL group than in the HDL group (P<0. 05). There was no significant difference in ALT between the BDL group and CE group (P>0. 05), and no significant difference in AST, ALT, TBIL, and DBIL between the HDL group and CE group (P>0. 05). Pathology showed that biliary hyperplasia and biliary wall thickening were most serious in the BDL group, least serious in the HDL group, and moderate in the CE group. CT showed that the extrahepatic bile duct diameter was larger in the BDL group than in the HDL and CE groups (P<0. 05), but there was no significant difference between the HDL and CE groups (P> 0. 05). Liver CT value decreased after surgery in the BDL group (P< 0. 05), and showed no significant difference after surgery between the HDL and CE groups (P>0. 05). Conclusions Both the CE and HDL models effectively prolonged the course of cholestasis in rats, and better simulated human extrahepatic cholestasis diseases, suggesting their utility for dynamic observation of the course of cholestasis.

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王思宇,张迎红,刘林秀,鲁仁财,何 宏,王绍波.三种术式大鼠肝外型胆汁淤积模型的对比研究[J].中国比较医学杂志,2020,30(10):14~20.

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  • 收稿日期:2020-02-28
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  • 在线发布日期: 2020-11-25
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