蒙脱石散与美沙拉秦对溃疡性结肠炎大鼠肠上皮细胞凋亡的影响  

Effect of montmorillonite powder and mesalazine on intestinal epithelial cell apoptosis in rats with ulcerative colitis

作　　者：远孟梦 熊晶晶[1] 赵川[2] 胡红卫[1] 刘梅[1] 赵亚玲[1] 丁臻博[1] 黄永坤[1] 

机构地区：[1]昆明医科大学第一附属医院儿科,云南省昆明市650032 [2]昆明医科大学第一附属医院病理科,云南省昆明市650032

出　　处：《世界华人消化杂志》2014年第26期3911-3917,共7页World Chinese Journal of Digestology

基　　金：益普生腹泻基金资助项目;No.IDF-2012-01~~

摘　　要：目的:研究蒙脱石散、美沙拉秦及美沙拉秦联合蒙脱石散对2,4,6-三硝基苯磺酸(2,4,6-trinitrobenzene sulfonic acid,TNBS)诱导的溃疡性结肠炎(ulcerative colitis,UC)大鼠肠上皮细胞凋亡的影响.方法:82只♂SD大鼠,随机分为正常组、模型组、干预组,干预组包括蒙脱石散组、美沙拉秦组,美沙拉秦联合蒙脱石散组.采用TNBS/乙醇法建立大鼠UC模型.确认模型建立后,模型组每天经口灌入生理盐水,干预组分别每天经口灌入蒙脱石散、美沙拉秦、美沙拉秦联合蒙脱石散.分别于灌胃满5 d和12 d时处死大鼠,剖取结肠标本采用原位末端标记法(terminal-deoxynucleoitidyl transferase mediated nick end labeling,TUNEL)测定细胞凋亡情况.结果:(1)模型建立成功:造模满24 h后大鼠出现腹泻、血便、体质量下降.结肠组织行光镜和电镜观察可见黏膜溃疡形成,并伴有中性粒细胞浸润、腺体结构破坏和杯状细胞减少;(2)肠组织细胞凋亡的检测结果:治疗5 d及12d的模型组、干预组与正常组相比,肠上皮细胞凋亡率明显增加(H5=439.78,H12=84.03,P=0.000);给药治疗5 d的3个干预组分别与治疗5 d的模型组比较,肠上皮细胞凋亡率明显降低(P=0.000);3个干预组间两两比较,美沙拉秦联合蒙脱石散组的凋亡率明显低于蒙脱石散组和美沙拉秦组(P=0.000);给药治疗12 d的3个干预组分别与治疗12 d的模型组比较,肠上皮细胞凋亡率明显降低(P=0.000);3个干预组间两两比较,美沙拉秦联合蒙脱石散组的凋亡率明显低于美沙拉秦组,美沙拉秦组明显低于蒙脱石散组(P=0.000);各干预组治疗12 d的凋亡率与本组治疗5 d的凋亡率相比明显减少(P=0.000).结论:研究表明肠上皮细胞凋亡参与了UC的发病过程,蒙脱石散与美沙拉秦联合治疗能抑制细胞凋亡,蒙脱石散能辅助美沙拉秦降低肠黏膜通透性,联合使用效果优于单独使用美沙拉秦的效果.单独药物或联合药物治疗12 d的效�AIM： To assess the effect of montmorillonite powder （Smecta） and mesalazine, alone or in combination, on intestinal epithelial cell apop- tosis in rats with 2,4,6-trinitrobenzene sulfonic acid （TNBS） induced colitis.domly divided into a normal group, a model group and three intervention groups including Smecta group, mesalazine group, and mesalazine plus Smecta group. Ulcerative colitis （UC） was induced in rats by the TNBS/ethanol method. The model group was daily treated with normal saline, and the intervention groups were intragas- trically treated with Smecta, mesalazine, mesala- zine plus Smecta, respectively. Rats were killed on days 5 and 12 after treatment to collect colon specimens. Terminal-deoxynucleoitidyl transfer- ase mediated nick end labeling （TUNEL） method was used to assay intestinal cell apoptosis rate. RESULTS： The rats treated with TNBS/ethanol had diarrhea with bloody stools and weight loss 24 h after model creation. Light and electronic microscopic analyses showed large mucosal ulceration area accompanied by neutrophil infiltration, damaged gland structural and de- creased goblet cells. Compared with the normal group, intestinal epithelial cell apoptosis rates in the model group and three intervention groups were significantly increased on days 5 and 12 （H5 = 439.78,H12 = 84.03, P = 0.000）. Compared with the model group, intestinal epithelial cell apop- tosis rates in the three intervention groups were significantly lower on days 5 and 12 （P = 0.000）. The apoptosis rates in the combination group were more significantly lower than those in the two monotherapy groups （P = 0.000）. The apop- tosis rates in the three intervention groups on day 12 were more significantly lower than those on day 5 （P = 0.000）.CONCLUSION：Intestinal epithelial cell apopto-sis is involved in the pathogenesis of UC. Mont-morillonite powder combined with mesalazinetherapy has a synergistic inhibitory effect onapoptosis. The inhibitory effect on apoptosis isbetter on day 12 than on d

关 键 词：蒙脱石散 美沙拉秦 溃疡性结肠炎 细胞凋亡 

分 类 号：R574.62[医药卫生—消化系统]