肝硬変モデルラットにおける門脈圧亢進性腸症の検討 Experimental portal hypertensive colopathy in rats with liver cirrhosis

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thioacetamide(TAA)を用いて作製した肝硬変・門脈圧亢進ラットに色素混入ラテックスを門脈本幹より注入し,大腸血管像を組織標本と透明標本で観察した.粘膜固有層から固有筋層までの樹枝状の静脈の蛇行・拡張・増加(WT)と,くも状血管腫様の拡張血管の集合像(VE)の所見を得た.一方,肝硬変症患者38例の大腸内視鏡検査でWTおよびVEと類似した所見が得られ,それぞれの陽性率は78.9%,65.8%とコントロール(10%,7.5%)に比し有意に高かった.以上よりWTとVEは門脈圧亢進性腸症(PHC)の所見と考えられた.PHCは比較的初期の肝硬変,門脈圧亢進症においても出現することが示唆され,TAAによる門脈圧亢進ラットはPHCの実験モデルとして適切と考えられた.

To elucidate the morphological feature of portal hypertensive colopathy (PHC), the macroscopic and microscopic vascular alterations of colonic mucosa was observed in rats with thioacetamide-induced liver cirrhosis. The colered latex was injected into the portal vein and filled the peripheral veins on the colonic mucosa. Histologic study revealed an increased in the number of the cross sections of venous vessels containing the colered lactices in the lamina propria mucosa (LP), lamina submucosal (SM) and muscularis propria (MP) in the cirrhotic rats. Stereoscopic results of the vascular cast obtained from the cirrhotic rats showed the presence of two characteristic vascular sings, i.e., winding and tree like dilated vessels (WT) and vascular ectasia (VE). WT was characterized by tortuosity, dilatation and increase of the venous vessels in the LP, SM and MP, and VE was vascular spider-like lesion mainly in the LP or a clump of tortuous vessels in LP, SM and MP. In the clinical study, 38 patients with liver cirrhosis and 40 normal control received colonoscopic examinations. The vascular lesions similar to WT and VE were seen in 78.9% and 65.8% of cirrhotic patients, compared to 10.0% and 7.5% in the control. The differences were statistically significant indicated that WT and VE were thought to be the typical experimental models of PHC. Since the cirrhotic rats used the present study were administered thioacetamide for only 12 weeks, it was suggested that PHC could occurred even in early stage of liver cirrhosis with mild portal hypertension. Neither WT nor VE were associated with the Child-Pugh's grade of cirrhosis.

収録刊行物

  • 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology

    日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 99(6), 584-592, 2002-06-05

    The Japanese Society of Gastroenterology

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