重型肝炎患者肠道分泌性IgA的变化  

The change of secretory IgA of gut in hepatitis gravis

作　　者：刘冬妍[1] 刘沛[2] 

机构地区：[1]中国医科大学附属盛京医院实验研究中心,110004 [2]中国医科大学附属盛京医院传染科,110004

出　　处：《山西医药杂志（上半月）》2008年第10期875-877,共3页Shanxi Medical Journal

摘　　要：目的研究重症肝炎患者肠道分泌性IgA(sIgA)的变化,了解重症肝炎患者伴发腹部症状的原因。方法采用免疫散射比浊方法、放射免疫方法、免疫组织化学方法和双免疫荧光方法检测重症肝炎患者血清、粪便和肠组织sIgA的变化。结果肝病患者血清、粪便IgA、sIgA均显著高于正常对照组(P<0.01,P<0.05);重症肝炎患者粪便IgA、sIgA和血清sIgA又显著高于其他肝病组(P<0.01)。重型肝炎肠组织分泌片(SC)染色较正常肠组织明显减弱,甚至难见,IgA染色也明显减弱。肠道SC、IgA免疫组织化学吸光度分析显示重症肝炎患者肠组织SC、IgA较正常组明显降低(P<0.01)。肠道双免疫荧光染色显示正常肠组织肠上皮细胞质(分泌的SC)呈橘红色,膜上sIgA呈黄色,固有层活化淋巴细胞呈橘红色或黄色;重型肝炎肠组织肠上皮细胞质、膜染色均明显减弱。结论重型肝炎患者肠上皮细胞质和膜上SC、IgA和sIgA减少导致肠道免疫屏障损伤,引起肠道免疫防御功能减弱,导致肠道屏障功能发生异常是引起腹部症状的原因之一。Objective To study the change of secretory （slgA） of gut in hepatitis gravis and to explore the reason why severe hepatitis patients were accompanied by abdominal symptom. Method IgA and sIgA in serum and faeces of severe hepatitis were examined by immunity rate nephelometry and radioimmunoassay. IgA and SC （SIgA） of intestinal tissues in hepatitis gravis were detected by immunohistochemistry, sIgA of intestinal epithelial cells in hepatitis gravis were detected by double immunofluorescence. Result Compared with the controls, the levels of IgA and sIgA in the serum and faeces were notably elevated in hepatic diseases （P 〈 0.01, P 〈 0.05）. The levels of IgA and sIgA in the fecal and the level of SIgA in the serum were notably elevated in hepatitis gravis compared with the other hepatic diseases （P 〈 0.01 ）. SC and IgA in the cytoplasm and on the membranes of intestinal epithelial cells in hepatitis gravis were remarkably decreased. The OD of SC and IgA was notably decreased compared with normal control （P〈 0.01 ）. Double immunofluorescence result showed that normal intestinal epithelial cytoplasm was tangerine, membranes were yellow, and plasma cells within the lamina propria were tangerine arid yellow, but intestinal epithelial cytoplasm, membranes and plasma cells within the lamina propria in hepatitis gravis were remarkably decreased. Conclusion The decrement of IgA and SC （sIgA） as well as SIgA in the cytoplasm and on the membranes of intestinal epithelial cells in hepatitis gravis induced falling of intestinal immunological barrier and the attenuation of intestinal immunological defense. This is one of the reasons which cause abdominal symptom in hepatitis gravis.

关 键 词：肝炎 胃肠道 免疫球蛋白A 分泌 

分 类 号：R575.1[医药卫生—消化系统]