摘要
目的观察胆汁反流引起食管粘膜的炎症损伤和组织细胞凋亡情况。方法以手术制造的十二指肠胃食管混合反流(DGER)大鼠模型为基础,制备DGER(A组)模型;DGER+LosecMupus制剂灌注造成单纯十二指肠液食管反流(B组)模型;DGER+胆管接扎造成无胆汁的十二指肠胃食管反流(C组)模型。观察9周后各组大鼠食管病理学改变,TUNEL法观察食管粘膜凋亡指数,免疫组化观察Fas蛋白的表达。结果A、B、C三组均发生反流性食管炎表现,炎症以A组最重,其次为B组,C组最轻。A、B两组均见Barrett's食管发生,发生率差异无统计学意义(P>0.05),C组无Barrett's食管发生;细胞凋亡结果示A组凋亡指数最高,其后依次为B组和C组(P<0.01);各组Fas蛋白表达均阴性。结论不含胆汁的DGER所致食管损伤最轻,胆酸可能与Barrett's食管的发生密切相关;各病理组的凋亡情况均增加,但与Fas系统无关。
Objective To investigate the esophageal mueosal inflammation and apoptosis indueed by reflux of different duodenal or bile in rats. Methods Esophagus division in esophagogastric junction and then esophagoduodenostomy were performed on rats to make the models of duodenogastroesophageal reflux （DGER）. Three kinds of reflux model, DGER （Group A）, duodenoesophageal reflux without gastric juice （Group B） and DGER without bile （Group C） were made by adjusting the DGER models. 9 weeks after operation, the esophageal mueosal inflammation was examined under mieroseope, and the esophageal apoptosis was tested by DNA fragmentation in situ using TdT-mediated dUTP biotin nick end labling （TUNEL）. Immunohistoehemieal method was used to deteet the status of esophageal Fas protein （CD95） assoeiated apoptosis. Results Evidenees of reflux esophagitis were seen in all rats with different reflux models. Esophageal inflammation was most severe in group A, then in group B, and the slightest in group C. Barrett＇s esophagus was seen in group A and group B but not in group C, and the incidence was found to be of no difference between the A and B groups （P〉0. 05）. Esophageal mueosal apoptosis index in group A was （7.05±1.44）%, being significantly higher than that in group B （5.25± 1.78）% and group C （2.84±1.36）%, （P〉0. 01）. The apoptosis index was significantly higher in group B than in group C （P〈0. 01）. Fas protein was negative in normal tissues and in all injured esophageal mueosal tissues. Conclusion The DGER without bile inflicts the slighest injury on the esophageal mueosa. Bile may play a signifieant role in the induetion of Barrett＇s esophagus. The apoptosis indiees inerease in groups A, B and C, but apoptosis is not eorrelated with Fas expression.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2006年第5期750-753,共4页
Journal of Sichuan University(Medical Sciences)
基金
卫生部临床学科重点项目(No.20012130)资助
关键词
十二指肠胃食管反流
炎症
凋亡
Duodenogastroesophageal reflux Inflammation Apoptosis
