急性重症胆管炎大鼠肠、肝、肺功能损伤的病生理机制及中药的保护作用

本研究分别采用１２５Ⅰ标记的牛血清白蛋白测定肺微血管通透性；电子自旋共振仪测定组织中氧自由基（ＯＦＲ）含量；生化方法测定组织中磷脂酶Ａ２（ＰＬＡ２）活力、肝细胞活力和肠粘膜中二胺氧化酶含量。结果显示：急性重症胆管炎（ＡＣＳＴ）时大鼠肺脏、肝脏和肠粘膜功能受到严重损害，表现在肺微血管通透性与对照组相比明显增加（Ｐ＜０．０１），肝细胞活力和肠粘膜二胺氧化酶活力明显低于对照组（Ｐ＜０．０１），与此相平行，三种组织中的ＯＦＲ和ＰＬＡ２水平明显高于对照组（Ｐ＜０．０１）。中药组的治疗效果最佳，而减压组和氨苄组的治疗效果较差甚至加重某些组织的功能损伤。不同治疗方法的结果与其对不同组织中ＯＦＲ和ＰＬＡ２的影响密切相关。我们还发现在ＡＣＳＴ，不同组织中ＯＦＲ与ＰＬＡ２的水平并不相同，肝脏的ＯＦＲ及肠管的ＰＬＡ２最高，肺脏和肝脏中的ＯＦＲ高于外周血中的ＯＦＲ。提示在ＡＣＳＴ时ＯＦＲ和ＰＬＡ２的产生主要发生在器官水平，单纯测定血浆中的含量难以反映各个器官内的真实水平。在文中我们还对ＡＣＳＴ时组织损伤发生的病生理机制和中药的作用机理进行了探讨。

Mechanism of Injury of Intestine, Liver and Lung in Acute Cholangitis of Severe Type Model and the Protective Effect of Huoxue Qingjieling

Lung capillary permeability was measured with 125 I labelled bovine serum albumin, the progression of hepato-cellular injury was quantitatively assessed using atriphenyltetrazolium chloride assay, injury of small intestinal mucosa was determined by the changes of diamine oxidase(DAO) level, content of oxygen free radicals(OFR) was measured by electron spin resonance spectrometer and levels of phospholipase A2(PLA2) of intestine, hepatocellular viability were observed by bioassay methods respectively. The results showed that function of lung, liver and intestine was seriously injuried in ACST rats. These injuries demonstrated by increase of capillary permeability and decrease of hepatocellular viability as well as DAO in intestinal mucosa(P<0.01) in comparing with control, while the levels of OFR and PLA2 in the above-mentioned 3 organs were elevated simultaneously(P<0.01). As for the comparison of efficacy of different treatment, Huoxue Qinglieling was the best one, the bile duct decompression or ampicillin showed little benefit on injury protection even aggravated in some tissues, they displayed a close relationship with their influence on the OFR and PLA2. Besides, the levels of OFR or PLA2 in various tissues were different from each other, therefore, the serum levels of OFR or PLA2 can not reflect the real levels occurred in organ or tissue level.