黏液填充在消化道上皮微缺损及肠屏障功能中的作用  

Mucus fills the intestinal epithelial gaps and maintains the barrier function

作　　者：周晓艳[1] 李铭[1] 郭婧[1] 左秀丽[1] 李延青[1] 

机构地区：[1]山东大学齐鲁医院消化内科,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第12期62-66,80,共6页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81330012);山东省科技发展计划(2013GGE27068)

摘　　要：目的探讨黏液是否参与填充肠上皮单层细胞间的微缺损(intestinal epithelial gaps,IEG),评价黏液填充IEG在局部肠屏障功能中的作用。方法取溃疡性结肠炎(UC)患者及对照组的回肠末端组织,用AB-PAS、M uc2标记黏蛋白,观察IEG及黏蛋白表达情况。另外,分析了2013年1月至2014年12月39例UC患者及34例对照共聚焦内镜图片,运用改良Watson分级方法评估局部肠屏障功能。结果 UC组IEG未被黏液填充率、上皮微缺损率、杯状细胞比率[M(P_(25),P_(75)),%]分别为27.52(25.00,29.68)、5.33(3.48,6.62)、17.38(16.00,19.87),对照组分别为12.27(9.78,16.67)、0.27(0.00,0.69)、23.44(20.24,26.18),两组差异均有统计学意义(P<0.01)。上皮微缺损率与杯状细胞比率呈负相关(r=-0.74,P<0.01)。结论 UC患者存在局部肠屏障功能障碍;黏液填充IEG,维持局部肠屏障功能。Objective To investigate whether mucus fills the intestinal epithelial gaps（ IEG）,and to explore the role of mucus in maintaining local barrier function. Methods The terminal ileum tissues of ulcerative colitis（ UC） patients and controls were obtained. Mucins were stained with Alcian Blue-Periodic Acid Schiff（ AB-PAS） and Muc2. In addition,we also analyzed the confocal laser endomicroscopy（ CLE） imagines of the terminal ileum from 39 UC patients and 34 controls since January 2013 to December 2014. Revised Watson grading system was used to evaluate the local barrier function. Results In UC patients,the proportion [M（ P_（25）,P_（75））,%]of IEG without mucus,intestinal epithelial gaps,goblet cells were 27. 52（ 25. 00,29. 68）,5. 33（ 3. 48,6. 62） and 17. 38（ 16. 00,19. 87）,respectively. In control group,these three parameters were 12. 27（ 9. 78,16. 67）,0. 27（ 0. 00,0. 69） and 23. 44（ 20. 24,26. 18）,respectively. The differences were statistically significant in the two groups（ P〈0. 01）. The proportion of intestinal epithelial gaps and goblet cells showed a significantly negative correlation（ r =- 0. 74,P〈0. 01）. Conclusion The local barrier function is lost in UC patients; mucus filled with IEG play a key role to maintain the local intestinal barrier function.

关 键 词：肠上皮微缺损 肠屏障功能 黏液 共聚焦内镜 杯状细胞 

分 类 号：R574[医药卫生—消化系统]