Zhang Hong-feng, Xue Ying-wei
Department of Abdominal Surgery, Affiliated Tumor Hospital, Harbin Medical University, Harbin, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2008 Sep;11(5):472-6.
To study the precise cause and the specific procedure about gastric mucosal lesion in rats with water immersion-restraint stress(WRS).
One hundred and forty-four Wistar rats were divided into 9 groups randomly: A, B, C, D, E, F, G, H and I group. There were 16 rats in each group. A, B and C groups underwent gastric emptying determination. Emptying rate of gastric fluid was determined with radiate nuclide (99m)Tc. D, E and F groups underwent gastric acid secretion determination after cleaning gastric contents and pylorus ligation. G, H and I groups underwent gastric acid secretion determination after pylorus ligation without cleaning gastric contents. Gastric mucosal lesion ulcer index(UI) was evaluated. The relationship between of gastric mucosal lesion and gastric emptying rate and gastric acid secretion were examined.
Gastric emptying rate decreased obviously when the WRS time was prolonged. There were significant differences among B (WRS 2 h), C group (WRS 4 h) and A group (controlled group) (P<0.01). There was also significant difference between B and C group (P<0.01).The rats' gastric acid secretion was inhibited significantly. The differences among E (WRS 2 h), F (WRS 4 h) and D groups (controlled group) were significant (P<0.01). There was no significant difference between F and E groups (P>0.05). The gastric mucosal lesions were aggravated with time of stress. Gastric contents cleaning could effectively prevent gastric mucosal lesions originated by stress .The operation had no influence on this test. There were significant gastric mucosal lesion UI in B and C groups compared with A group (P<0.01). The difference between B and C group was significant (P<0.01).There were no gastric mucosal lesions in A, D, E, F and G groups. However, There was significant difference between I and F group (P<0.01). No significant difference were found among A, D, E, F and G groups (P>0.05). There were significant difference between H and B group and also between I and C group (P<0.01).
WRS can induce gastric emptying disturbance, reduce gastric acid secretion and cause gastric mucosal lesion. As a factor inducing gastric mucosal lesion, acid can damage gastric mucosa as long as it exists without necessary peracid. The prolongation of acid with gastric mucosa contact period and the decrease of gastric mucosa resistance are perhaps the major causes of gastric mucosal lesion. Besides anti-acid, giving facilitative gastric emptying drugs and gastric lavage during stress ulcer prevention and cure should be considered. Acid evacuation in time is also a major cure for gastritis and recurrent ulcer.
研究水浸束缚应激(WRS)大鼠胃黏膜损伤的确切原因及具体过程。
将144只Wistar大鼠随机分为9组:A、B、C、D、E、F、G、H和I组,每组16只。A、B和C组进行胃排空测定,采用放射性核素(99m)Tc测定胃液排空率。D、E和F组在清洗胃内容物并进行幽门结扎后测定胃酸分泌。G、H和I组在幽门结扎后不清洗胃内容物测定胃酸分泌。评估胃黏膜损伤溃疡指数(UI)。检测胃黏膜损伤与胃排空率及胃酸分泌之间的关系。
随着WRS时间延长,胃排空率明显降低。B组(WRS 2小时)、C组(WRS 4小时)与A组(对照组)之间差异有统计学意义(P<0.01)。B组和C组之间也有显著差异(P<0.01)。大鼠胃酸分泌明显受到抑制。E组(WRS 2小时)、F组(WRS 4小时)与D组(对照组)之间差异有统计学意义(P<0.01)。F组和E组之间无显著差异(P>0.05)。胃黏膜损伤随应激时间加重。清洗胃内容物可有效预防应激引起的胃黏膜损伤。该操作对此试验无影响。与A组相比,B组和C组胃黏膜损伤UI有统计学意义(P<0.01)。B组和C组之间差异有统计学意义(P<0.01)。A、D、E、F和G组无胃黏膜损伤。然而,I组和F组之间有显著差异(P<0.01)。A、D、E、F和G组之间无显著差异(P>0.05)。H组和B组之间以及I组和C组之间有显著差异(P<0.01)。
WRS可导致胃排空紊乱、胃酸分泌减少并引起胃黏膜损伤。作为导致胃黏膜损伤的因素,酸只要存在即可损伤胃黏膜,不一定需要胃酸过多。胃酸与胃黏膜接触时间延长及胃黏膜抵抗力降低可能是胃黏膜损伤的主要原因。在预防和治疗应激性溃疡时,除使用抗酸药物外,还应考虑给予促进胃排空的药物及进行洗胃。及时排出胃酸也是治疗胃炎和复发性溃疡的主要方法。