摘要
目的 探讨胆道梗阻后心脏损害及损害机制。方法 分动物及临床实验 ;胆道结扎并离断 ,大鼠行颈动脉插管测心率、血压、心输出量 ,动态观测心肌组织丙二醛 (MDA )和超氧化物歧化酶 (SOD)、血清总胆红素 (TBil)、胆汁酸 (TBA)、内毒素 (ET)、肿瘤坏死因子 (TNFα)含量 ,ABC免疫组化法定位 TNFα在心肌组织中的表达和分布。临床以放射性同位素对胆道梗阻病人行心血池显像 ,得出左心室功能参数。结果 胆道梗阻后大鼠血压、平均动脉压、心输出量下降 ,血清 TBil、TBA、ET、TNFα、心肌组织 MDA逐渐升高 ,SOD逐渐减少 ,胆道梗阻组与对照组比较 ,P<0 .0 5 ,心肌组织 MDA含量与血清 TNFα含量变化呈正相关 ,r值分别为 0 .932和 0 .85 0 ,光电镜检查心肌组织细胞 ,随胆道梗阻时间延长损害加重。胆道梗阻组病人局部射血分数 REF3和 REF4、轴缩短率 RS3和 RS4明显低于对照组。结论 胆道梗阻后心脏功能受损且随黄疸加深而损害加重 ,自由基损伤、内毒素血症。
Objective To investigate cardiac injury after biliary obstruction and its mechanism.Methods Heart rate、blood pressure、cardiac output the contents of myocardium malondial dyhyde(MDA),superoxide dismutase(SOD),serum T bil,TBA,endotoxin(ET) and tumor necrosis factor(TNFα) on the rats model of biliary obstrution were measured after performing carotid arterial cannulatio.Left ventricle as drawn for optical and electronic microscope observation.Immunohisto chemical technique was used to detect the expression and distribution of TNFα in myocardium.Result After BDL,serum T Bil、TBA、ET、TNFα levels and myocardium MDA were increased significantly while SOD decreased markedly,which compared with control group( P <0.05).The high content of myocardium MDA content was positively related the serum TNFα Levels.There were less myocardial injuries in control groups than that in BDL groups with optical and electronic microscope observation.Conclusions Myocardium of rats will be injuried after biliary obstruction.ET,TNFα and myocardium free radical injury may be the important mechanisms of myocardial injury induced by biliary obstruction.
出处
《肝胆外科杂志》
2003年第6期465-467,共3页
Journal of Hepatobiliary Surgery
关键词
胆道梗阻
心脏
自由基
biliary obstruction
myocardium
free radical
TNFα
injury
