慢性束缚应激对大鼠食管上皮屏障的影响  

Effect of chronic restraint stress on esophageal epithelial barrier function： experiment with rats

作　　者：赵丹云[1] 段丽萍[1] 朱元莉[1] 李志强[1] 

机构地区：[1]北京大学第三医院消化科,100083

出　　处：《中华医学杂志》2008年第26期1837-1840,共4页National Medical Journal of China

基　　金：国家高技术研究发展计划“863”计划基金资助项目（2007AA022423）

摘　　要：目的研究慢性束缚应激（CRS）对大鼠食管上皮屏障的影响，探讨精神心理因素在胃食管反流病发病中的作用。方法成年雄性SD大鼠随机分为4组（各6只）：对照组；CRS组（连续束缚应激7d，每天2h）；酸灌注组（以4ml／h的速度于麻醉状态下远端食管灌注酸化胃蛋白酶60min）；CRS＋酸灌注组。光学显微镜观察食管黏膜组织学改变，透射电镜评估食管上皮细胞间隙变化。结果CRS组大鼠平均每日进食量和7d体重增长量均显著低于对照组（均P〈0．01）；CRS组大鼠食管上皮细胞间隙宽于对照组[（0．457±0．031）μm vs（0．235±0．027）μm，P〈0．01]；对照组和CRS组大鼠酸灌注60min后，CRS＋酸灌注组食管黏膜组织学评分显著高于酸灌注组（2．33±0．33 vs 1．33±0．33，P〈0．05），两组细胞间隙均增宽，且CRS＋酸灌注组较酸灌注组增宽更为明显[（0．516±0．010）μm vs （0．441±0．021）μm，P〈0．05]。结论CRS可导致大鼠食管上皮细胞间隙明显增宽，破坏食管上皮屏障功能，产生类似于食管内酸灌注的食管形态学变化，在此基础上的酸灌注可进一步加重黏膜的损伤。为阐明精神心理因素可导致胃食管反流病及功能性烧心患者症状产生和加重的机制提供实验基础。Objective To investigate the effect of chronic restraint stress （CRS） on the esophageal epithelial barrier function and discuss the role of emotional factors in the pathogenesis of gastroesophageal reflux. Methods Twenty-four male SD rats were randomly divided into 4 equal groups： CRS group submitted to partial restraint stress 2 h per day for 7 days, CRS ＋ acid/pepsin perfusion group submitted to partial restraint stress 2 h per day for 7 days and then anesthetization and perfusion of hydrochloric acid （pH =2） and pepsin （1 g/L） into the distal esophagus at the speed of 4 ml/h for 60 min, acid/pepsin perfusion group submitted to acid/pepsin perfusion into the esophagus, and control group. Then the rats were killed to collect the specimens of distal esophagus to undergo HE staining and light microscopy. Histological scoring was conducted. The diameter of intercellular spaces of esophageal epithelium was assessed. Results The amounts of food intake and body weight increment of the CRS and CRS ＋ acid/pepsin perfusion groups were significantly lower than those of the control and acid/pepsin perfusion groups （ all P 〈 0.01 ）. The histological score of the CRS ＋ acid/pepsin perfusion group was the highest. The diameter of intercellular spaces of esophagus of the CRS ＋ acid/pepsin perfusion group was （0. 516 ±0. 010） μm, significantly greater than those of the CRS, acid/pepsin perfusion, and control groups [ （0.457 ± 0.031 ） μm, （0.441 ± 0.021 ） μm, and （0. 235 ± 0.027 ） μm respectively, P 〈 0.01 or P 〈 0.05 ]. The histological score of the CRS ＋ acid/pepsin perfusion group was 2.33±0. 33, significantly higher than those of the CRS, acid/ pepsin perfusion, and control groups （ 1.17 ±0.31, 1.33 ±0.33 ; and 0.33 ± 0.21 respectively, P 〈 0.05 or P 〈 0.01 ）. Conclusion CRS enlarges significantly the esophageal DIS and impairs the epithelial barrier function of the esophagus. Psychological factors induce or enhance the reflux symptom in the GERD patients,

关 键 词：应激 胃食管反流 大鼠 细胞外液 

分 类 号：R686[医药卫生—骨科学]