| Abstract:Objective:To investigate the effect of the different drainage and the changes of intestinal barrier using a rat obstructive jaundice model, so that it enables to provide more experience for clinical treatment of the obstructive jaundice patients. Methods:60healthy SD rats, weighing200-250g, were divided into four groups, which were Sham-operated (SH) group (only mobilized the bile duct); Obstructive jaundice model (OJ) group (the ligation of common bile duct); Internal drainage (ID) group (drained the bile towards intestine after the ligation of common bile duct); External drainage (ED) group (drained the bile outwards the abdomen after the ligation of common bile duct). One week later, specimens from the rats in SH and OJ groups were collected. Moreover, the specimens in ID and ED group also were harvested seven days post the drainage. Heart blood collected serum, the liver function and the TNF-a levels were determined by automatic biochemical analyzer and radioimmunoassay. sIgA level in intestine mucus was examined using ABC-ELISA and terminal ileum tissues was stained with HE staining.SPSS13.0software statistical analysis, P<0.05was considered statistically significant. Results:1. Serum TNF-a level:The TNF-a level in SH group, OJ group, ID group, ED group were2.66±0.44pg/ml,14.97±6.15pg/ml,3.72±2.10pg/ml,15.21±2.45pg/ml respectively. Among these results, the TNF-a level in OJ group elevated statistically compared with SH group and ID group(P<0.05);ED group showed statistically higher than SH group and ID group(P<0.05).2. sIgA in intestine mucus:The level of sIgA in SH group, OJ group and ID group, ED group were0.345±0.010pg/ml,0.170±0.150pg/ml,0.272±0.182pg/ml,0.181±0.113pg/ml respectively. Among these results, the level of sIgA in SH group elevated statistically compared with OJ group, ED group and ID group(P<0.05);ID group showed statistically higher than OJ group and ED group(P<0.05).3.Liver function indicators:①ALT: the ALT level in OJ group, SH group, ID group and ED group were560.23±103.65U/L,75.01±19.87U/L,78.53±17.66U/L, and88.23±23.74U/L respectively. Among these results, the level in OJ group showed statistical higher outcome than SH group, ID group, and ED group (P<0.05); while there was no significant difference between ED and ID group (P>0.05).②TBIL:the TBIL level in OJ group, SH group, ID group and ED group were157.14±51.43μmol/L,1.04±0.49μmol/L,1.24±0.78μmol/L,1.34±0.35μmol/L respectively. Among these results, the level in OJ group showed statistical higher outcome than SH group, ID group, and ED group (P<0.05); while there was no significant difference between ED and ID group (P>0.05).③DBIL:The DBIL level in OJ group, SH group, ID group and ED group were137.49of±45.37μmol/L,0.43±0.24μmol/L,0.46±0.41μmol/L,0.64± 0.68μmol/L respectively. Among these results, the level in OJ group showed statistical higher outcome than SH group, ID group, and ED group (P<0.05); while there was no significant difference between ED and ID group (P>0.05).④TBA:The TBA level in OJ group, SH group, ID group and ED group were113.91±17.67μmol/L,6.53±2.65μmol/L,8.06±2.16μmol/L,7.47±3.04μmol/L respectively. Among these results, the level in OJ group showed statistical higher outcome than SH group, ID group, and ED group (P<0.05); while there was no significant difference between ED and ID group (P>0.05).4. Pathological observation:After HE staining, the slides was observed under microscope.SH groups:intact mucosa, the villi arranged in neat rows, organizational structure integrity, without inflammatory cell infiltrated. OJ group:Mucosal atrophy, villi sparse, messy, shedding, glands rupture the continuity of the epithelial damage, inflammatory cell infiltrated. ID group:Intact mucosa, the fluff was a little sparse, the good continuity of the epithelium, closer to the SH group, no inflammatory cell infiltrated. ED Group:Mucosal integrity and the continuity of the epithelium restore slightly, the fluff sparse destruction inflammatory cell infiltrated. Compared the small intestine pathology:For the recovery of the intestinal mechanical barrier function, the ID group was better than the ED group. Conclusion:In this study, by observing the specimens changing, we can get the following conclusions:1. When obstructive jaundice happens, the liver as well as the intestinal membrane barrier damages with the increase of serum TNF-a level and reduction of sIgA level in intestine;2. As the methods of unblock the obstruct of bile duct, it is proved that eternal bile drainage shows superior to external drainage attributed to higher slgA, lower TNF-a and better outcome of the protection of intestinal membrane barrier and liver function. |
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