Türkçapar Nuran, Bayar Sancar, Koyuncu Ayhan, Ceyhan Koray
Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey.
Hepatogastroenterology. 2003 May-Jun;50(51):680-3.
BACKGROUND/AIMS: The protective effect of octreotide on bacterial translocation, bile duct epithelial proliferation and hepatic fibrosis was studied in an experimental obstructive jaundice model.
Forty-five healthy Wistar albino rats were randomly divided into three groups. Group I (n = 15): Median laparotomy and common bile duct manipulation performed (Sham group). Group II (n = 15): Laparotomy and common bile duct ligation performed. Group III (n = 15): After laparotomy and common bile duct ligation octreotide (Sandostatin, sandoz) was given. Simultaneously group I and II received 3 cc 0.9% NaCl and group III received 20 micrograms/kg/daily octreotide subcutaneously every 8 hours during 9 days. Two days after the procedure all rats were opened under ether anesthesia and sterile conditions. Group I had simple laparotomy but group II and III also had common bile duct ligation by 5/0 prolene. Seven days after the surgery (9th day after treatment) all rats underwent laparotomy and tests for bacterial translocation, liver biochemical tests and histopathologic analysis of liver and small bowel were carried out.
In group II cecal population levels of bacteria were significantly higher than group I and group III (p < 0.05). In group II there was also statistically significant bacterial translocation to the mesenteric lymph nodes. Pathological changes were found in terminal ileum samples in group II which seemed to improve in group III. Hepatocyte function was preserved with octreotide treatment which also significantly decreased bile duct proliferation and periportal fibrosis in response to biliary obstruction.
This experimental study showed that octreotide is effective in preventing bacterial translocation, bile duct proliferation and hepatic fibrosis in obstructive jaundice.
背景/目的:在实验性梗阻性黄疸模型中研究奥曲肽对细菌移位、胆管上皮细胞增殖和肝纤维化的保护作用。
45只健康的Wistar白化大鼠随机分为三组。第一组(n = 15):行正中剖腹术并对胆总管进行操作(假手术组)。第二组(n = 15):行剖腹术并结扎胆总管。第三组(n = 15):剖腹术及胆总管结扎术后给予奥曲肽(善宁,山德士公司)。同时,第一组和第二组大鼠每天皮下注射3 cc 0.9%氯化钠溶液,第三组大鼠在9天内每8小时皮下注射20微克/千克/天的奥曲肽。术后两天,所有大鼠在乙醚麻醉和无菌条件下开腹。第一组仅行单纯剖腹术,而第二组和第三组还用5/0普理灵线结扎胆总管。术后7天(治疗后第9天),所有大鼠再次剖腹,进行细菌移位检测、肝脏生化检测以及肝脏和小肠的组织病理学分析。
第二组盲肠细菌数量水平显著高于第一组和第三组(p < 0.05)。第二组中细菌向肠系膜淋巴结的移位也具有统计学意义。第二组末端回肠样本出现病理改变,而第三组似乎有所改善。奥曲肽治疗可保留肝细胞功能,同时也显著减少了胆管增生和门静脉周围纤维化,以应对胆道梗阻。
本实验研究表明,奥曲肽在预防梗阻性黄疸中的细菌移位、胆管增生和肝纤维化方面有效。