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电子显微镜观察在阻塞性黄疸实验模型中肝和肾损伤。

An electron microscopy study of liver and kidney damage in an experimental model of obstructive jaundice.

出版信息

Ann Ital Chir. 2020;91:122-130.

Abstract

UNLABELLED

With this experimental study we investigated the consequences of ligation of the common bile duct (CBD) on hepatic cells and on the renal ultrastructure by electron microscopy and also determine the effects after liberation of the ductus joint in order to clarify the mechanisms of renal failure commonly observed in cholestatic liver disease. The study was conducted on 53 Wistar albino rats divided into 4 subgroups. In the comparison group (sham) we proceeded to the simple laparotomy. After preparation of the common bile duct of all the rats of the four groups, and ligation of the duct at the level of the distal third, eight rats in each group were sacrificed on the 3rd, 7th, 10th and 14th day after surgery, taking blood samples to measure the serum levels of ALP and bilirubin, and liver and renal tissue samples for histological evaluation. In four rats of each group the common bile duct was unligated at the same deadlines to obtain free drainage of the bile for a week. At the end of this week, the rats were sacrificed by collecting blood and liver and kidney tissue samples.

RESULTS

after CBD ligation in both groups, the ALP value, total and direct bilurubin levels were proportionally increased. After duct release, bilurubin levels decreased significantly. In group II, while large lipid granules were observed to indicate oxidative damage, mitochondrial swelling and crystals were observed after duct liberation. Areas of glycogen and normal mitochondria were observed in group IV. After duct release in this group, increases in Ito granules, lipid granules and normal mitochondria were observed, which may reflect the evolution of hepatic regeneration. When renal tissue was examined in group II, fusion processes in the feet, thickening of the basement membrane and mesengium were observed, and mitochondrial crystals were observed in renal tissue as well as in the liver after duct release. Damage in group III and group IV was increased parallel to prolongation of jaundice and after loosening persistent damage with mitochondrial crystals.

CONCLUSION

Ultrastructural changes in rat liver tissue in conditions of obstructive jaundice may be reversible after restoration of drainage. On the other hand, ultrastructural changes in renal tissue in cases of prolonged jaundice are irreversible even if the internal drainage is restored.

KEY WORDS

Bile Duct, Liver, Kidney, Obstructive Jaundice.

摘要

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本实验研究通过电子显微镜观察胆总管(CBD)结扎对肝细胞和肾脏超微结构的影响,并确定胆管松解后的效果,以阐明在阻塞性胆汁淤积性肝病中常见的肾衰竭机制。研究对象为 53 只 Wistar 白化大鼠,分为 4 组。在对照组(假手术)中,我们仅进行简单的剖腹手术。在对四组所有大鼠的胆总管进行准备后,在胆总管远端三分之一处结扎胆管,每组 8 只大鼠分别于术后第 3、7、10 和 14 天处死,取血样测量血清碱性磷酸酶(ALP)和胆红素水平,并取肝、肾组织样本进行组织学评估。每组的 4 只大鼠在相同的截止日期处解除胆总管结扎,以使胆汁自由引流一周。在这一周结束时,处死大鼠,收集血液和肝、肾组织样本。

结果

在两组 CBD 结扎后,ALP 值、总胆红素和直接胆红素水平均相应升高。胆管松解后,胆红素水平显著下降。在组 II 中,观察到大脂质颗粒表明存在氧化损伤,胆管松解后观察到线粒体肿胀和晶体。在组 IV 中观察到糖原和正常线粒体区域。在该组胆管松解后,观察到 Ito 颗粒、脂质颗粒和正常线粒体增加,这可能反映了肝再生的演变。在观察肾组织时,在组 II 中观察到足细胞融合过程、基底膜和间质增厚,以及胆管松解后在肾组织和肝脏中观察到线粒体晶体。在组 III 和组 IV 中,随着黄疸时间延长,损伤加重,即使解除内引流,持续存在的损伤仍伴有线粒体晶体。

结论

在恢复引流的情况下,阻塞性黄疸大鼠肝组织的超微结构变化可能是可逆的。另一方面,在长时间黄疸的情况下,肾组织的超微结构变化是不可逆的,即使恢复了内部引流。

关键词

胆管、肝、肾、阻塞性黄疸。

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