Nieuwenhuijs V B, van Dijk J E, Gooszen H G, Akkermans L M
Gastrointestinal Research Unit, Department of Surgery, University Medical Centre, Utrecht, The Netherlands.
Digestion. 2000;62(4):255-61. doi: 10.1159/000007824.
BACKGROUND/AIMS: Translocation of gut bacteria occurs in obstructive jaundice, the underlying mechanisms are unclear. We designed this experimental study to investigate the association between interdigestive motility and the pathogenesis of bacterial translocation during biliary obstruction.
Rats were fitted with jejunal myoelectrodes for the measurement of the interdigestive migrating motor complex (MMC) and with two cannulas in the proximal common bile duct (CBD) for exteriorization of biliary flow. This allowed measurement of MMCs under control conditions with an intact enterohepatic circulation and during 3 days of CBD obstruction without surgical intervention. Mesenteric lymph nodes, liver, spleen and segments of the duodenum, the jejunum and the caecum were removed for microbial culturing.
The MMC cycle length increased from 17.3 min before CBD obstruction to 31.9, 34.1, and 25.3 min on days 1, 2 and 3, respectively, after CBD obstruction (p < 0.05 for all days). Bacterial levels in the jejunum were significantly higher in CBD-obstructed rats than in control rats. The translocation incidence was significantly higher in rats with CBD obstruction (6/8) than in control rats (1/8). The bacterial levels in the jejunum correlated significantly with the MMC cycle length (r = 0.60, p <0.05).
Experimental biliary obstruction is associated with disturbance of MMCs, small-bowel bacterial overgrowth and increased bacterial translocation.
背景/目的：肠道细菌易位在梗阻性黄疸中会发生，但其潜在机制尚不清楚。我们设计了这项实验研究，以探讨消化间期运动与胆道梗阻期间细菌易位发病机制之间的关联。
给大鼠安装空肠肌电电极以测量消化间期移行性运动复合波（MMC），并在肝总管近端插入两根套管以引出胆汁流。这使得能够在肝肠循环完整的对照条件下以及在肝总管梗阻3天且无手术干预的情况下测量MMC。取出肠系膜淋巴结、肝脏、脾脏以及十二指肠、空肠和盲肠段进行微生物培养。
肝总管梗阻前MMC周期长度为17.3分钟，肝总管梗阻后第1、2和3天分别增加至31.9、34.1和25.3分钟（所有天数p<0.05）。肝总管梗阻大鼠空肠中的细菌水平显著高于对照大鼠。肝总管梗阻大鼠的易位发生率（6/8）显著高于对照大鼠（1/8）。空肠中的细菌水平与MMC周期长度显著相关（r = 0.60，p<0.05）。
实验性胆道梗阻与MMC紊乱、小肠细菌过度生长和细菌易位增加有关。
