胆汁内引流对梗阻性黄疸大鼠胃黏膜的保护作用及机制

目的：探讨不同胆汁引流方式对梗阻性黄疸（OJ）大鼠肠黏膜的影响及机制。 方法：将80只SD大鼠随机均分为假手术组、OJ模型组（模型组）、OJ模型+胆汁内引流组（内引流组）；OJ模型+胆汁外引流组（外引流组）。实验共2周，结束时，处死各组大鼠，观察胃黏膜形态学变化，检测血清内毒素、内皮素1（ET-1），胃黏膜ET-1、内皮素受体A（ET-A）mRNA表达。 结果：除假手术组外，各组大鼠均有不同程度的胃黏膜损伤，但内引流组的损伤情况明显较模型组与外引流组为轻；与假手术组比较，模型组和外引流组大鼠血清内毒素、ET-1和胃黏膜ET-1水平和ET-A mRNA表达明显升高，差异均有统计学意义（均P<0.05），内引流组以上指标轻度升高，差异无统计学意义（均P>0.05）。 结论：胆汁内引流对OJ大鼠胃黏膜有保护作用，机制可能与其降低ET-1水平和ET-A的表达有关。

Protective effect of internal biliary drainage on gastric mucosa in rats with obstructive jaundice and the mechanism

Objective: To investigate the effects of different biliary drainage methods on gastric mucosa in rats with obstructive jaundice (OJ) and the mechanisms. Methods: Eighty SD rats were randomized into sham operation group, OJ model group (model group), OJ model plus internal biliary drainage group (internal drainage group), and OJ model plus external biliary drainage group (external drainage group), and the total experiment time was two weeks. At the end of the experiment, rats in each group were sacrificed and the histological changes in gastric mucosa were observed; the serum endotoxin and endothelin 1 (ET-1) levels, and ET-1 level and endothelin receptor type A (ET-A) mRNA expression in gastric mucosal tissues were determined. Results: All rats, except those in sham operation group, showed gastric mucosal injury of varied severity, but the injury in internal drainage group was remarkably milder than that in either model group or external drainage group. Compared with sham operation group, the serum endotoxin and ET-1 levels, and ET-1 and ET-A mRNA expression levels in gastric mucosal tissues in both internal drainage group and external drainage group were markedly increased, and all differences reached statistical significance (all P<0.05), while they were slightly increased in internal drainage group, but with no statistical differences (all P>0.05). Conclusion: Internal biliary drainage exerts protective effect on gastric mucosa in OJ rats, and the mechanism is probably due to its reducing ET-1 level and ET-A expression.