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己酮可可碱和泼尼松龙对胆道梗阻后继发门脉纤维化演变的影响——生长动物的实验研究。

Effects of the administration of pentoxifylline and prednisolone on the evolution of portal fibrogenesis secondary to biliary obstruction-an experimental study in growing animals.

机构信息

Pediatric Surgery Division, Laboratory of Pediatric Surgery, University of Sao Paulo Medical School, CEP 01246-903 Sao Paulo, Brazil.

出版信息

J Pediatr Surg. 2009 Nov;44(11):2071-7. doi: 10.1016/j.jpedsurg.2009.05.020.

Abstract

BACKGROUND

Many chronic liver diseases lead to progressive hepatic fibrosis, a condition that can ultimately result in loss of organ function and severe portal hypertension necessitating hepatic transplantation. Within the last few decades, studies have been conducted to demonstrate the possibility of drug modulation of hepatic fibrogenesis. Regarding biliary obstruction, it has been suggested that administration of corticosteroids could promote better late outcomes for children with biliary atresia submitted to Kasai's portoenterostomy. Models used to test potential antifibrogenic drugs such as pentoxifylline (PTX) have not included growing animals.

METHODS

In this experimental study, 119 young rats (21st or 22nd days) were submitted to laparotomy and common bile duct ligation (CBDL) or to sham surgery (SHAM). Animals were allocated into 5 groups, according to surgical procedure, and administered the following solutions: (1) CBDL + distilled water, (2) SHAM + distilled water, (3) CBDL + PTX, (4) CBDL + prednisolone (PRED), and (5) CBDL + PTX + PRED (PTX + PRED). Each group was further divided into 2 subgroups according to the length of the experiment (15 or 30 days). At the end of the defined period, animals were weighed, and a hepatic fragment was collected from each one for analyses.

RESULTS

The PTX animals exhibited increased weight gain compared to animals in the PRED or PTX + PRED groups. Animals from the 3 therapeutic groups (PTX, PRED, and PTX + PRED) showed diminished collagen-filled area in portal spaces. Total portal space area was increased in the PTX group.

CONCLUSIONS

Hepatic fibrosis induced by bile duct ligation in young rats could be modulated by pharmacologic interventions. Administration of PTX or PRED, or the combination of both, resulted in diminished collagen-filled areas in portal spaces.

摘要

背景

许多慢性肝病导致进行性肝纤维化,这种情况最终可能导致器官功能丧失和严重的门静脉高压,需要进行肝移植。在过去的几十年中,已经进行了研究,以证明药物调节肝纤维化发生的可能性。关于胆道阻塞,已经有人提出,皮质类固醇的给药可能会促进胆道闭锁患儿接受 Kasai 门腔分流术的更好的后期结果。用于测试潜在抗纤维化药物(如己酮可可碱(PTX))的模型未包括生长中的动物。

方法

在这项实验研究中,119 只幼鼠(第 21 或 22 天)接受剖腹术和胆总管结扎术(CBDL)或假手术(SHAM)。根据手术程序将动物分为 5 组,并给予以下溶液:(1)CBDL +蒸馏水,(2)SHAM +蒸馏水,(3)CBDL + PTX,(4)CBDL +泼尼松龙(PRED)和(5)CBDL + PTX + PRED(PTX + PRED)。每个组根据实验的时间长度(15 天或 30 天)进一步分为 2 个子组。在规定的时间结束时,对动物进行称重,并从每个动物采集肝组织片段进行分析。

结果

与 PRED 或 PTX + PRED 组的动物相比,PTX 动物的体重增加更多。来自 3 个治疗组(PTX、PRED 和 PTX + PRED)的动物的门管区胶原填充面积减少。PTX 组的总门管区面积增加。

结论

幼鼠胆总管结扎诱导的肝纤维化可通过药物干预来调节。给予 PTX 或 PRED,或两者的组合,可导致门管区胶原填充面积减少。

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