閉塞性黄疸時における上部消化管出血の成因に関する実験的検討
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概要
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Pathogenesis of the acute gastric mucosal lesion in obstructive jaundice was studied experimentally in relation to its higher incidence under combined stress. The bile duct ligation for 4 weeks in rats and restraint in water bath of ambient temperature for 4 hours were used as the models of obstructive jaundice in animals and combined stress, respectively. Pathogenesis was mainly discussed in changes of amines' contents and energy production in stomach, duodenum and liver. Pathological findings of the stomach were also added to the discussion. Pathological findings of the gastric mucosal cells revealed that the slight and superficial erosion in obstructive jaundice became deeper and wider in the presence of combined stress. Histamine content in the gastric mucosa showed the trend of decrease alone in obstructive jaundice and remarkable decrease ; in obstructive jaundice with coexisting stress, while histamine content in the liver increased in obstructive jaundice without further increase by stress. Noradrenaline content in gastric mucosa showed the significant decrease in obstructive jaundice and tendency of further decrease in obstructive jaundice with combined stress. Noradrenaline content in the liver also decreased in obstructive jaundice. No changes of contents in both amines were found in the duodenal mucosa in obstructive jaundice, which agreed with no pathological changes there. Contents of ATP and cytochrome C+C_1 showed the significant decrease in obstructive jaundice but no further decrease in combined stress in both gastric mucosa and liver, revealing that energy production had been already depressed maximally in obstructive jaundice. Thus, it might be concluded that gastric mucosa in obstructive jaundice was in the preceding stage of ulcer formation histologically and biochemically and was manifestive in combined stress to yield bleeding.
- 神戸大学の論文