Cited 0 times in

37 0

實驗的 肝損傷이 胃酸分泌에 미치는 影響

Other Titles
 Effect of experimentally-induced hepatic injury on gastric acid secretion 
Issue Date
1979
Description
의학과/박사
Abstract
[한글] 胃外분비응 주로 신경, hormone 및 histamine에 의해 조절 지배된다. 胃臟과 肝臟은 기능상 상호 관련성을 가져 임상적으로 肝경변증에 소화성괴양의 병발빈도가 높다(3.6~25%)고 보고하고 있다.Tabaqchali 및 Dawson(1961)은 肝경병증만 있을때는 胃液分泌가 감소되나, 肝경변증에 소화성괴양이 합병해 있을때는, 위액분비가 증가되어 있다고 하며, 이와같은 현상은 위액분비항진因子를 함유한 門脈血行이 肝을 통과하지 않고, collaterals를 통하여 肝外순환되기 때문이라고 해석하였다.(CAstanedad등, 1960; Gregory,1958).위액분비자극因子로는 gastrin, acetylcholine 및 histamine이 대표적 물질이다. 肝세포 microsome내의 약물대사효소는 肝세포smooth endoplasmic reticulum에 농축되어 있는데(Fouts,1 961)phenobarbital투여로 현저히 증가되고, enzyme induction이 야기되어 많은 약물이 빨리 대사된다. Cameron 및 Karunaratne(1936)이 쥐에 CCl^^4투여하여 肝障害를 유발시킴을 관찰한 아래, 肝損傷기전에 대한 많은 연구가 있었으나 아직 명확히 규명되지 않았다.Suga(1972)는 CCl^^4 복강내 투여로 위액 pH가 대조군보다 감소하고, histamine 이나 gastrin을 투여한 후에도 감소한다고 보고하였다. Phenobarbital이나 CCl^^4 투여로 肝障害된 상태에서 위액분비 자극제를 투여하여 분비반응을 비교 검색한 문헌이나, 수술로 肝부분절제를 시행하여 肝損傷상태에서 위액분비반응을 관찰한 문헌은 극히 드물다. 본 실험에서는 체중 200g내외의 흰쥐를 사용하였다. 예비실험으로는 肝非障害군에 위액분비자극제인 histamine(2.5mg/kg), methacholine(5μg/kg)을 각각 투여하여 Shay등(1945)의 방법으로 채취한 위액의 분비량 및 酸度를 측정 검색하였다. 또한 위액분비봉쇄제인 cimetidine(1.0mg/kg), atropine(1.0mg/kg) 및 prolumide(20.0mg/kg)를 투여한 후 위액분비자극제를 각각 투여하여 상호관련성을 비교 검색하였다. 본실험으로는 phenobarbital 이나 CCl^^4(20% olive 油 2.5ml/kg)등의 약물을 복강내로 투여하거나, 60~70% 肝부분절제수술로 실험적 肝기능변조를 일으킨 흰쥐에 분비자극제를 투여하여, 그 효과를 비교 검색하였다. 1. 肝非障害상태에서, histamine, methacholine 및 tetragastrin의 전형적 위산분비항진반응을 관찰할 수 있었다. 2. 肝非障害상태에서, histamine 자극위액분비는 cimitidine 또는 atropine으로 억제되나 proglimide로는 억제되지 않았고, methacholine 자극위산분비는 atropine으로만 억제되고, tetragastrin 자극위산분비는 proglimide투여로만 경미하게억제 되었을 뿐이다. 3. Phenobarbital전처치로 인한 肝대사효소항진상태에서는 위外분비자극제의 작용을각별히 변화시키지 못하였으나, 위산분비 자극반응이 훨씬 둔화되었다. 4. CCl^^4전처치로 인한 실험적 肝기능저하상태에서는 위外분비자극반응에 차이를 나타내, methacholine반응은 볼 수 없고, histamine반응은 월등 증강되었다. 5. 肝부분절제동물의 위外분비자극반응은 미약하였다. 이상의 결과를 종합하여 보면, 肝非障害상태에서는 histamine위산분비반응은 cimetridine이나 atropine으로 억제되고, methacholine 분비반응은 atroline투여로만 억제되며,tetragastrin분비반응은 proglumide로 경한 억제를 나타냈다. 약물 혹은 수술적으로 肝기능을 변조시키면 위外분비반응이 變動됨으로 보아, 肝이 위外분비기능에 중요역활을 함을 알 수 있다.
[영문] It is known that gastric function is mainly under the controls of nerve, hormones and histamine. Clinical reports suggest that there is a relationship between gastric secretion and liver function. Tabaqchali, et al.(1961) reorted that healthy cirrhotics had reduction of gastric sectrtion, but patients with peptic ulcer and cirrhosis had significantly higher secretory pattern than those with cirrhosis aline. In addition, many authors found relatively high incidence of peptic ulcer in patients with hepatic cirrhosis. Swisher, et all. (1955) suggested a few possible factors which might increase the predilection towards peptic ulceration in the physiological and pathological states present in cirrhosis, such as 1) absence or relative absence of newtralizing bile salts from gastrointestinal tract, 2) stimulatory effect of alcohol on hydrochloric acid secretion, and 3) direct inflammatory effects of alcohol on gastric and duodenal mucosa. Many other factors have also been claimed. This study was undertaken to establish the role of liver to gastric acid secretion, In order to investigate this relationship, as first the effects of histamine, methacholine and tetragastrin on gastric acid secretion were observed in reats. Secondly, in the altered states of liver function with such as chemical or surgical manipulation, the effects of the gastric response by secretory stimulants were also observed. Albino reats weighing about 200 g were used for the study, Phenobarbital as well as CCl^^4 were administered intraperitoneally. In hepatectomized rats the response was observed at right after and 1, 2 and 3 weeks after operation. Secretory response was observed by secretagogues. Shay's method was used for the gastric secretion test and the acidity of gastric juice was determined by using Titrator TTT 2b. The results were summerized as follows: 1) The typical stimulation of gastric secretion was showed by histamine, methacholine as well as tetragastrin in cintrol rats. 2) The histamine-induced secretion was blocked significantly by cimetidine or atropine, but not by proglumide. Gastric secretion due to methacholine was lbocked only by atropine, while proglumide inhibited slightly the stimulatory effect of tetragastrin. 3) In the group pretreated with phenobarbital, which induces metabolizing enzymes in liver, the stimulatory effects on gastric secretion by methacholine, tstragastrin and histamine were less prominet in comparison with that of the control group. 4) In the group pretreated with CCl^^4 which cause liver damage, the gastric secretory response by histamine was enhanced, however the effect of methacholine was rather decreased significantly. 5) In the partially-hepatectomized animals, the responses to gastric simulants were slight or were not elicited. From the above results, it could be suggested that the liver has an important role for the gastric exocrine function.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/126823
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 박사
사서에게 알리기
  feedback
Fulltext
교내이용자 서비스로 제공됩니다.
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse