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全胃肠外营养或腹腔感染诱导大鼠胆汁淤积的组织病理学研究

Histopathologic study of cholestasis induced by total parenteral nutrition or intraperitoneal sepsis in rats.

作者信息

Shu Z J, Li J S, Zhou Z S, Shi Q L, Zhang T H

机构信息

Department of Abdominal Surgery, Jinling Hospital, Nanjing, People's Republic of China.

出版信息

JPEN J Parenter Enteral Nutr. 1991 Nov-Dec;15(6):630-6. doi: 10.1177/0148607191015006630.

Abstract

Wistar rats were divided into two groups, intraperitoneal sepsis group (group IS) and total parenteral nutrition group (group TPN), to evaluate the characteristics of pathologic alterations in rats with cholestasis. Biochemical assay showed that cholestasis developed in both groups after 10 days. Light microscopic examination of liver specimens revealed that the degeneration in the intermediate and external zone of hepatolobules was the major alteration in group IS, and group TPN showed characteristic dilation of central veins and hepatic sinuses and the proliferation of Kupffer cells with marked phagocytosis. Electron microscopic pictures presented the enlargement of bile canaliculi with altered microvilli in group IS and many highly electron-dense bile particles within cytoplasm and secondary lysosomes near dilated bile canaliculi in group TPN. It is concluded that there were different histopathologic alterations of liver specimens in TPN-supported animals and septic animals when cholestasis developed. It is unsuitable to take intraperitoneal sepsis as a unique factor of cholestasis in TPN-supported rats. Bile stasis is only one sign of TPN-induced hepatic lesion, which needs further exploration to determine its causes and mechanisms.

摘要

将Wistar大鼠分为两组,即腹腔内脓毒症组(IS组)和全胃肠外营养组(TPN组),以评估胆汁淤积大鼠的病理改变特征。生化检测显示,两组在10天后均出现胆汁淤积。肝标本的光镜检查显示,肝小叶中区和外周区的变性是IS组的主要改变,而TPN组则表现为中央静脉和肝血窦的特征性扩张以及库普弗细胞的增殖,并伴有明显的吞噬作用。电镜图片显示,IS组胆小管扩张,微绒毛改变,而TPN组在扩张的胆小管附近的细胞质和次级溶酶体内有许多高电子密度的胆汁颗粒。结论是,当发生胆汁淤积时,接受TPN支持的动物和脓毒症动物的肝脏标本存在不同的组织病理学改变。将腹腔内脓毒症作为TPN支持大鼠胆汁淤积的唯一因素是不合适的。胆汁淤积只是TPN诱导肝损伤的一个迹象,其原因和机制尚需进一步探索确定。

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