肝内胆管结石和胆管炎的兔模型

目的应用胆总管部分梗阻加感染法建立模型,观察肝胆管结石成石情况、胆管和肝组织的病理变化。方法将胆总管结扎至1.45mm粗细,注入动物标准致病菌O157K88大肠杆菌液2.5×104菌株/kg,术后3周、5周、7周取材,观察肝叶质量变化,肝胆管成石情况,做HE、VG染色。结果受累肝叶萎缩纤维化,未累及的肝右叶代偿肥大;建模3周胆管成石率为87.5%,胆囊成石率为75.0%,5周、7周成石率全部为100%,各兔形成结石数量多少不等。3周时胆管上皮坏死脱落,有黏膜下小脓肿形成,管壁周围大量中性粒细胞浸润,肝细胞肿胀,空泡样变性,汇管区炎性细胞浸润,呈急性化脓性胆管炎改变;5周时上皮细胞增生,壁内壁外见黏液细胞增生,胆管腔内见脱落上皮细胞和蓝染的结石,壁周纤维结缔组织增生,仍有大量中性粒细胞和淋巴细胞浸润,肝细胞空泡样变性,汇管区纤维结缔组织增生,肝小叶结构破坏;7周时胆管上皮增生增厚更加明显,壁内外黏液细胞增多,胆管壁纤维增生,汇管区纤维结缔组织增生,间隔增宽,肝细胞数目减少,肝小叶破坏,有假小叶形成,呈慢性增生性胆管炎改变。结论量化胆总管梗阻程度和细菌量建立模型成功率高,成石率高。肝内胆管结石是以慢性增生性胆管炎为病理学基础的。

Rabbit' s model of intrahepatic bile duct stone and cholangitis

Objective To establish the animal model of hepatolithiasis in rabbit through the measure of obstruction and infection,and observe formation calculus ratio of intrahepatic bile duct and the pathological changes of bile duct and hepatic tissue.Methods Common bile duct was deligated to broad 1.45mm,and injected pathogenic bacterium O157K88 2.5×104 strain each kilogram.The materials were drew from hepatic tissue to observe hepatic lobe’s weigh,formation calculus ratio and hepatic pathological changes after 3weeks,5weeks,7weeks.Results 87.5% rabbits were found to have hepatolithiasis in 3rd week and 100% in 5th week and 7th week.During the formation process of calculus,the acute inflammation in the biliary duct system and hepatic tissue was transferred to the chronic one.Under the microscope,we discovered pathological character of chronic proliferative cholangitis displays cellula epithelialis proliferation,tubal wall fibrosis,inflammatory cells infiltration,collagen hyperplasia,fabric separation widen,hepatic lobules destruction and notho-lobules formation.Conclusion Quantifying common bile duct obstruction degree and bacterial dose to establish the animal model has super-achievement ratio and formation calculus ratio,and hepatolithiasis pathology characteristic display chronic proliferative cholangitis.