摘要
目的明确抑酸治疗是否影响胶体次枸橼酸铋的吸收和代谢;观察铋剂在大鼠重要脏器中沉积的具体位置以及沉积器官中细胞功能的改变。方法将体重200～250g的48只雄性SD大鼠随机分为5组:A1组:单用胶体次枸橼酸铋(CBS),停止喂药时处死。B1组:单用CBS,停药8周后处死。A2组:采用四联(CBS+奥美拉唑+羟氨苄青霉素+甲硝唑)治疗,停止喂药时处死。B2组:采用同上四联治疗,停药8周后处死。对照组:给予蒸馏水。每日各喂药1次,共14d。取各组大鼠肝、脑、肾组织,AMG染色后复染,光镜下观察铋剂在组织中的沉积部位并进行灰度测量值比较。在电镜下观察铋剂在胞质中的具体沉积部位及胞质细胞器的受损程度,并通过电镜能谱分析的方法来确定样品中的化学元素成分是否为铋元素。结果铋剂吸收入血后,可以在肝脏汇管区细胞、下丘脑细胞、舌下神经核细胞及肾近曲小管细胞中蓄积,光镜下近曲肾小管细胞、肝汇管区细胞、下丘脑外侧区前区神经细胞中发现铋颗粒的存在,吸收的铋剂最后可以以髓样小体的形式经肾脏排出体外。灰度测量比较发现四联用药组比单一用药组铋的肾脏蓄积量要大(P<0.05),停药8周后肾脏的蓄积量均较前明显减少(P<0.01)。电镜观察肾近曲小管细胞质的溶酶体中特异性地聚集着大量黑色颗粒并存在可逆性的细胞受损表现。
Objective To investigate whether the acid suppression therapy influences the absorption of bismuth from colloidal bismuth subcitrate (CBS); to locate the deposit position of bismuth in mice′s organs and to detect the consequential change of cell functions in these deposited organs. Methods 48 male SD rats weighing from 200-250g were randomly divided into five groups: Group A 1, kill the rats on the cessation day of administration CBS; Group B 1, kill the rats on the day 8 weeks after the cessation of administration CBS; Group A 2 (CBS+ amoxicillin + metronidazole + omeprazole), kill the rats on the cessation day of administration; Group B 2 (CBS+ amoxicillin + metronidazole + omeprazole), kill the rats on the day 8 weeks after the cessation of administration; Control group. These medicines had been taken every day for 14 days. The issue sections (liver, brain and kidney) were counterstained after AMG development. The bismuth deposited in tissues was observed by microscopy. At the same time, the gray level of kidney tissue sections were measured and compared through image processing program. The deposition of bismuth and the degrees of cell organ′s impairment were observed through electron microscopy. By the use of electron probe microanalysis, bismuth can be distinguished from chemical element.Results The bismuth can be accumulated in cell bodies of proximal convoluted renal tubule, portal area, hypothalamus, and hypoglossal nuclei after its absorption. Under the light microscopy, heavy AMG staining granules were found in cell bodies of proximal convoluted renal tubule. It was discovered that the amounts of bismuth accumulation in kidney of quadruple therapy group were much more than that of single compound therapy group(P<0.05). The amounts of bismuth accumulation in kidney on the cessation day of administration are more than that 8 weeks later(P<0.01). What is more, under the electron microscopy, heavy AMG staining granules were found exclusively in lysosomes of proximal convoluted renal tubule cell. The electron microscopy found some cell impairment in quadruple therapy group: the impairment to these cells can be recovered 8 weeks after the cessation of administration.Conclusions The acid suppression therapy causes an increase of bismuth absorption and accumulation from CBS in the rats′ kidney. Finally, the absorbed bismuth can be discharged out of the body via kidney. Large amounts of bismuth accumulation in kidney can impair the functions of proximal convoluted renal tubule cell.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2005年第4期272-275,共4页
Chinese Journal of Internal Medicine
