小儿急性肠套叠细菌移位的相关研究  

Bacterial translocation in children with intussusception

作　　者：靳园园[1] 王建峰[1] 席红卫[2] 

机构地区：[1]山西医科大学儿科系,太原030001 [2]山西省儿童医院普外科

出　　处：《中华小儿外科杂志》2010年第10期749-752,共4页Chinese Journal of Pediatric Surgery

基　　金：山西省科技攻关项目（编号：20080311064-2）

摘　　要：目的 探讨小儿急性肠套叠细菌移位及机制.方法 应用聚合酶链反应（PCR）定性检测细菌共有的16 SrRNA和大肠杆菌特异性β半乳糖苷酶基因BG;肠系膜淋巴结细菌培养;免疫组织化学方法检测组织Bcl-2、Bax的表达.结果 正常对照组全血16SrRNA、大肠杆菌BG未检出,空气灌肠复位组16SrRNA阳性率30%,BG阳性率20%;手术复位组16SrRNA阳性率50%,BG阳性率60%,肠系膜淋巴结培养阳性率为50%;肠坏死肠切除组16SrRNA阳性率60%,BG阳性率70%,肠系膜淋巴结培养阳性率为60%;与对照组相比,肠套叠手术组凋亡调控基因Bcl-2、Bax表达明显升高,Bcl-2/Bax比值变小.结论 小儿急性肠套叠应用PCR技术早期可诊断细菌移位,而肠套叠肠缺血再灌注损伤诱导Bcl-2、Bax蛋白表达,是引起肠黏膜细胞凋亡最终发生细菌移位可能的机制.Objective To investigate bacterial translocation and its mechanism in children with intussusception; Methods Polymerase chain reaction （PCR） was performed after DNA extraction, with target β-1actosidase gene （BG） of E. coli and 16SrRNA gene of most pathogenic bacteria. Bacteria in mesenteric lymph nodes were cultured. Bcl-2 and Bax in intestinal tissue were determined by immunohistochemical assay. Results Bacteria DNA were not detected in the control group; In the air reduction group and operation reduction group, 16SrRNA were positive in 30% and 50% of the patients respectively, E. coli BG were positive in 20% and 60% respectively. In the intestine resection group, 16SrRNA was positive in 600/00 of patients, E. coli positive rates were 70%; In operation group and the intestine resection group, positive cultural rate of E. coli in mesenteric lymph nodes was 50% and 60%. Comparing with the control group, the expression of Bcl-2 and Bax were significantly elevated in intussusception-operated group, Bcl-2/Bax ratio was smaller. Conclusions Polymerase chain reaction （PCR） can detect of bacterial translocation early in children with intussusception. The expression of Bcl-2 and Bax were possibly induced by intestinal ischemia-reperfusion during intussusception, Intestinal apoptosis may eventually lead to bacterial translocation.

关 键 词：肠套叠 细菌移位 基因 BCL-2 

分 类 号：R686[医药卫生—骨科学]