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目的探讨孕鼠肝内胆汁淤积症对母鼠和胎鼠心脏的影响。方法应用雌、孕激素建立妊娠肝内胆汁淤积大鼠模型,光镜和电镜观察母鼠和胎鼠心脏的病理改变。结果(1)胆淤组和对照组比较,孕鼠血清丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、总胆汁酸(TBA)的差异有显著性(P<0.01)。(2)胆淤组孕鼠肝脏光镜下见部分肝细胞有颗粒样变性和空泡变性,电镜下见肝组织中毛细胆管扩张,毛细胆管及肝细胞内见高电子致密物沉积。(3)胆淤组孕鼠胎盘光镜下见部分滋养细胞颗粒样变性和空泡变性。(4)胆淤组孕鼠心脏光镜下见心肌组织中局灶性心肌细胞颗粒样变性。(5)胆淤组胎鼠心脏光镜下见心肌组织中心肌细胞广泛空泡变性;电镜下见胎鼠心肌细胞内高电子致密物沉积,部分肌丝断裂,肌节模糊,细胞内线粒体水肿,脱髓鞘样改变。结论孕鼠肝内胆汁淤积症时高胆汁酸血症对母鼠和胎鼠心肌细胞均有明显的毒性作用,尤其以胎鼠心肌细胞病变更为严重。
Objective To investigate the effects of intrahepatic cholestasis of pregnant rats on the heart of maternal and fetal rats. Methods The rat model of intrahepatic cholestasis of pregnancy was established by estrogen and progesterone. The pathological changes of the heart were observed under light and electron microscopes. Results (1) Compared with the control group, the serum ALT, AST and TBA in pregnant rats were significantly different (P <0.01). (2) Part of liver cells were found to be degeneration of granular cells and vacuolated degeneration under the light microscope in liver of pregnant rats with cholestasis. Electron microscope showed the enlargement of capillary bile ducts in liver tissue, and the deposition of high electron dense material in capillary bile ducts and hepatocytes. (3) Part of trophoblast granulocyte degeneration and vacuolar degeneration in placenta of pregnant rats with cholestasis group. (4) Focal microglization of focal myocardial cells in myocardium was observed under light microscope in pregnant rats with cholestasis. (5) The cardiomyocytes of gallbladder group showed extensive vacuolar degeneration of cardiomyocytes in myocardial tissue. Electron microscope showed the deposition of high electron density, some myofilament rupture, mitochondria edema , Demyelination-like changes. Conclusions Hyperbilirubinemia in pregnant rats with intrahepatic cholestasis has obvious toxic effects on myocytes and fetal rat cardiomyocytes, especially in fetal rat cardiomyocytes.