摘要
目的 观察溃疡性结肠炎（UC）患者的肠道屏障功能,并探讨其临床意义.方法 收集2010年3月至2013年6月天津医科大学总医院诊断的200例UC患者肠黏膜标本,以40份正常肠黏膜组织为对照.200例UC患者依据Mayo评分分为轻度（68例）、中度（70例）和重度（62例）.以咬合蛋白（occludin）、分泌型免疫球蛋白A（sIgA）和β防御素（β-defensin）分别代表肠道机械屏障、免疫屏障和化学屏障,采用免疫组化法检测肠黏膜组织中3种蛋白表达,并与相关临床指标进行统计学分析.结果 与对照相比,UC患者肠黏膜中occludin、sIgA表达显著减少（28.53％±2.21％比44.28％±1.94％,19.26％±1.09％比28.36％±2.36％,均P＜0.05）,β-defensin表达显著增加（29.13％±1.75％比19.71％±1.83％,P＜0.05）.轻、中、重度UC患者间肠黏膜occludin、β-defensin表达差异均有统计学意义（均P＜0.05）;随着UC分级增加occludin表达明显减少（r=-0.753,P＜0.05）,β-defensin表达明显增多（r=0.698,P＜0.05）.而轻、中、重度UC患者间sIgA表达差异无统计学意义（P＞0.05）.UC患者中3种蛋白在不同性别、年龄、病变部位的表达差异无统计学意义（均P ＞0.05）.结论 UC患者出现肠道屏障功能损伤,随着临床分级增加,肠道机械屏障、化学屏障损伤更加明显.
Objective To discuss the variation of intestinal barrier and its clinical significance in patients with ulcerative colitis（UC）.Methods Specimens were obtained from 200 patients of UC and 40 controls respectively from March 2010 to June 2013.UC samples were classified into three groups as mild （n =68）,moderate （n =70） and severe （n =62） according to Mayo classification.Immunohistochemistry was performed to examine the expression of occludin,β-defensin and sIgA,which respectively reflect the changes of mechanical barrier,chemical barrier and immune barrier in intestinal tissue.The result and the clinical data were analyzed.Results Compared with controls,the expression of occludin and sIgA significantly decreased （28.53% ± 2.21% vs 44.28% ± 1.94%,19.26% ± 1.09% vs 28.36% ±2.36%,both P 〈 0.05）,β-defensin significantly increased （29.13 % ± 1.75 % 比 19.71% ± 1.83 %,P 〈 0.05） in UC group.There was a significant difference of occludin levels among different active subgroups （P 〈 0.05）,and the levels decreased significantly with the increase of UC classification （r =-0.753,P 〈 0.05）.β-defensin levels were significant differently among different active subgroups （P 〈 0.05）,and the levels increased significantly with the increase of UC classification （r =0.698,P 〈 0.05）.There was no significant difference in the sIgA levels among the three stages （P 〉 0.05）.In different gender,age and lesion site,there was no statistically significant difference in expression of three kinds of protein （all P 〉 0.05）.Conclusion UC patients exist intestinal barrier function injury,with the increase of UC classification,the damages of intestinal mechanical barrier and chemical barrier were more obvions.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第24期1941-1943,共3页
National Medical Journal of China
基金
黎介寿院士肠道屏障研究专项基金（LJS201008）
