Experimental Study Of The Effect Of Bile Disequilibrium On Biliary Duct Injury Of Obstructive Jaundice

Objective:To research the correlation of obstructive jaundice bile bases essential component alteration and with biliary duct injury, providing a new thread for clinically prevention and cure the preoperative hepatic calculus.Methods:Spragure-Dawley rats model of obstructive jaundice was set up and used in measurement at different time points of the level of jaundice. Different groups were divided in accordance with the level of jaundice. Group A (SO-IBD group:control group); Group B (OJ24h-IBD group:obstructive jaundice 24 hours-Intestinal bile drainage group); Group C(OJ168h-IBD group:obstructive jaundice 168 hours-Intestinal bile drainage group). Observe the change of postoperative of Bile flow, Total bile acid(TBA), y-glutamyltransferase(y-GT), Alkaline phosphatase(AKP), Total cholesterol (Tch) and Phospholipid. Determination of bile salts in rat bile by reverse phase high performance liquid chromatography(RP-HPLC). The TdT-mediated dUTP-Biotin nick and labeling(TUNEL) detected bile ducts apoptosis.Observe the change of bile ducts histomorphology.Analysis phosphatides;and correlation of bile change BS/PL biliary duct injury degree score.Results:1.The concentration of hydrophilic bile salts(TUDCA and THDCA) in group C significantly decreased to lower than group A after obstructed 168hours (p<0.05). The concentration of hydrophobic bile salts(TCA,TDCA.TCDCA.CDCA) in group C significantly increased to higher than group A (p<0.05).2. THDCA and TUDCA which was in group B and group C increased significantly after open drainage,but TCA,TDCA,TCDCA and CDCA which was in those groups obviously decreased.Hydrophobicity Index(HI) of bile salts in group C is higher than group A and group B after internal drainaged, the differences between eath other were statistically significant (p<0.05). HI of bile salts following the longer time decreased, and it was similar postoperative 14days.The increase of HI correlated strongly with the time of obstruction.3. The secretion of bile salts in group C is higher than group A and group B.It decreased following the longer time.and the bile salts/phospholipid ratio (BS/PL) in group C is obviously higher than group A,it decreased as time longer,and postoperative 7 days closed to others.4.Linear regression analysis suggested that biliary release of y-GT and ALP correlated strongly with the secretion of bile salts.5.The bile salts/phospholipid ratio was significantly higher in the group with a high bile duct injury severity score(BDISS), compared to the group with a low score.6.The TUNNEL assay showed that group C is obviously higher than group A at the beginning of postoperative,then group C and group B decreased to approach to group A, there was not statistically difference (p>0.05).Conclusion:1. The rat model with Obstructive jaundice-Intestinal bile drainage is suitable for the study of biliary problems which is stable, more physiological and easy to standardlize.2. OJ can increase the cytotoxicity of TBA via increasing the proportion of hydrophobic bile salts and decreasing the proportion of hydrophilic bile salts,and OJ can repress the secretion of phospholipid, leading to there is no enough phospholipid to antagonize the cytotoxicity of bile salts.