目的探讨阿苯达唑脂质体(L-ABZ)及槐耳浸膏(HEF)对小鼠肝细粒棘球蚴病术后感染的抑制作用,了解增强宿主免疫功能对本病术后复发的影响。方法雌性昆明小鼠,腹腔注射人肝细粒棘球蚴囊液,3周后取外周血IgG抗体阳性鼠,分为药物治疗组(A、B、C组)和模型对照组(D组),每组40只。A组灌胃L-ABZ(75mg/kg)、B组灌胃HEF(15000mg/kg)、C组两药联用(阿75mg/kg+槐15000mg/kg)。隔天1次,共3次。麻醉各组小鼠,打开腹腔,肝脏注射经PBS浸泡20min的原头节(0.3ml/只,约含原头节6000个,下同),模拟开放式外膜内外囊完整摘除术术中外溢原头节再感染。缝合关闭腹腔,72h后药物治疗组同法继续治疗1个月,D组灌服蒸馏水0.3ml/只。E组(8只正常小鼠)为空白对照。各组小鼠均于3个月后解剖。评价药物疗效(包括肝棘球蚴复发率、组织学观察、测定脾脏指数(SI)及IgG、IgE水平、流式细胞仪检测外周血CD4+、CD8+T淋巴细胞百分率)。另取上述外周血IgG抗体阳性鼠分为F、G、H和I4组,每组约30只,分别同上述A、B、C和D组同法灌胃治疗,于肝脏分别注射经20%NaCl、75%乙醇、L-ABZ及PBS浸泡20min的原头节,观察其感染率。结果C组肝棘球蚴复发率为5.7%,低于A组(17.1%)和B组(24.2%);棘球蚴色泽发白呈结节状,生发层和角质层破坏严重。脾脏指数(A组为3.84±0.86、B组为3.95±1.01、C组为3.27±0.52)和IgE水平(A组为0.06±0.08、B组为0.07±0.08、C组为0.03±0.03)均明显低于D组(分别为5.46±0.52及0.20±0.02)(P〈0.05),其中C组降低最为明显。CD8+水平,A组为16.61±3.89、B组为18.18±3.90、C组为15.38±2.63,均明显低于D组的32.90±4.71(P〈0.05)。CD4+/CD8+,A组为3.21±0.70、B组为3.05±0.66、C组为3.53±0.57,均明显高于D组的1.57±0.26(P〈0.05)。C组CD8+降低、CD4+/CD8+升高最为明显。F、G和H组肝棘球蚴感染率分别为0?
Objective To explore the effect of Huai-Er fungus extract (HED and liposome albendazole (L-ABZ) on the hepatic infection of Echinococcus granulosus (Eg) in mice, and understand the influence of improved host immunity on postoperative recurrence. Methods Female Kunming mice were immuned by intraperitoneal injection Eg cyst fluid from sheep, IgG positive mice were divided into drug treatment groups (A, B and C) and control group (D). Mice in group A were administered by gavage with single L-ABZ (75 mg/kg), group B with single HEF (15 000 mg/kg), and group C with combination therapy (L-ABZ 75 mg/kg plus HEF 15 000 mg/kg), once every two days for one week. The prostoscoleces were treated with balanced solution for 20 minute and inoculated in the liver by open abdomen of the anesthetized mice. Imitating to an "open sub-adventitial total exocystectomy", prostoscoleces outside the cyst led to a reinfection. 72 hours later, groups A, B and C were re-treated for a month. Mice in group D were given with distilled water(0.3 ml per mouse). Group E was set as blank control (n=8). Another 120 IgG positive mice were divided as groups F, G, FI and I, and treated in parallel with the groups A, B, C and D respectively; these mice were inoculated with prostoscoleces which were treated in advance with 75% alcohol, 20% hypertonic saline, L-ABZ and PBS for 20 rain respectively. In 3 months after infection, all the mice were sacrificed to evaluate the efficacy, which covered infection rate, pathological change, spleen index, level of IgG and IgE, CD4^+ and CD8^+ cells. Results The recurrence rate in group C (5.7%) was lower than that of groups A (17.1%) and B (24.2%), with hydatid cysts in white colour and nodular, showing degeneration of the germinal and laminated layers. Groups A, B and C showed lower spleen index (A: 3.84±0.86, B: 3.95± 1.01, and C: 3.27±0.52), and lower IgE level (A: 0.06±0.08, B: 0.07±0.08 and C: 0.03±0.03) than group D (5.46± 0