梗阻性黄疸促进肠道屏障功能障碍和细菌易位：实验研究。
Obstructive jaundice promotes intestinal-barrier dysfunction and bacterial translocation: experimental study.
机构信息
Department of Surgery, National Liver Institute, Menoufeyia University, Shibin El Kom, Egypt,
出版信息
Hepatol Int. 2007 Dec;1(4):444-8. doi: 10.1007/s12072-007-9018-1. Epub 2007 Sep 20.
BACKGROUND
Although clinical and experimental studies have demonstrated a correlation between obstructive jaundice and the development of sepsis, the mechanism has not been fully elucidated.
PURPOSE
The aim of this study was to investigate the influence of biliary obstruction on bacterial translocation as a possible source of infection in cases of obstructive jaundice.
MATERIAL AND METHODS
Two groups of 12 Wistar rats were examined: rats subjected to common bile duct (CBD) ligation (group A) and rats subjected to a sham operation (group B). After 7 days, blood samples were taken and liver, spleen, and mesenteric lymph nodes (MLNs) from the ileocecal area were removed, divided into small pieces, and cultured. Quantitative culture results were determined by the number of colony-forming units (CFU) per milliliter of homogenate. Bacterial translocation was defined as the presence of a positive culture of MLNs, blood, liver, and/or spleen. Samples for histopathological examination were taken from the mucosa of the ileum and the colon and evaluated for inflammatory and destructive changes.
RESULTS
There was no evidence of bacterial translocation to MLNs, blood, spleen, or liver detected in any of the 12 sham-operated control rats. In contrast, bacterial translocation was demonstrated in 8 of the 12 CBD-ligated rats (P < 0.01). In all eight cases in which translocation occurred, Escherichia coli were cultured from the MLNs. There were no histological changes in the mucosal samples of the control animals. In the CBD-ligated rats, hyperemia, vacuolization, reduction of goblet cells, decreased mitotic activity, and infiltration by lymphocytes and polymorphonuclear leukocytes (PMNLs) were detected. Cases in which translocation occurred were significantly associated with decreased mitotic activity in the colon (r = -0.5, P < 0.01) and higher infiltration by PMNLs in the ileum (r = -0.62, P < 0.05).
CONCLUSION
Obstructive jaundice in a rat model predisposes to bacterial translocation. This suggests a mechanism whereby jaundiced patients are susceptible to septic complication.
背景
尽管临床和实验研究已经证实阻塞性黄疸与脓毒症的发展之间存在相关性，但机制尚未完全阐明。
目的
本研究旨在探讨胆道梗阻对细菌易位的影响，因为细菌易位可能是阻塞性黄疸感染的来源。
材料和方法
检查了两组 12 只 Wistar 大鼠：胆总管结扎组（A 组）和假手术组（B 组）。7 天后，采集血样，并取出肝、脾和回肠-盲肠区域的肠系膜淋巴结（MLNs），切成小块，进行培养。通过每毫升匀浆的菌落形成单位（CFU）数量确定定量培养结果。细菌易位定义为 MLNs、血液、肝脏和/或脾脏的阳性培养。从回肠和结肠的黏膜中取出用于组织病理学检查的样本，并评估炎症和破坏变化。
结果
在 12 只假手术对照大鼠中，均未发现 MLNs、血液、脾或肝有细菌易位的证据。相比之下，在 12 只 CBD 结扎大鼠中有 8 只证实存在细菌易位（P < 0.01）。在所有 8 例发生易位的病例中，均从 MLNs 培养出大肠杆菌。对照动物的黏膜样本无组织学变化。在 CBD 结扎大鼠中，观察到黏膜充血、空泡化、杯状细胞减少、有丝分裂活性降低以及淋巴细胞和多形核白细胞（PMNLs）浸润。发生易位的病例与结肠有丝分裂活性降低（r = -0.5，P < 0.01）和回肠 PMNLs 浸润增加（r = -0.62，P < 0.05）显著相关。
结论
在大鼠模型中，阻塞性黄疸易导致细菌易位。这表明黄疸患者易发生感染性并发症的机制。
Zotero 插件