小儿急性肠梗阻肠坏死A2B腺苷受体、紧密连接蛋白Occludin的表达及临床意义  

Expression of adenosine A2B receptor and tight junction protein Occludin in children with acute intestinal obstruction necrosis and the clinical significance

作　　者：袁小锋 田霞 李红军 Yuan Xiaofeng;Tian Xia;Li Hongjun(Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]河南省许昌市中心医院,461000

出　　处：《中国实用医刊》2018年第14期4-8,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目（201404034）

摘　　要：目的 研究小儿急性肠梗阻A2B腺苷受体、紧密连接蛋白Occludin的表达及临床意义.方法 选择医院小儿科收治的30 例急性肠梗阻肠坏死患儿作为治疗组,30 例消化道畸形患儿作为对照组.两组患儿均行肠切除肠吻合术.检测方法：①免疫组化方式检测肠管黏膜上皮细胞中A2B腺苷受体（ A2BAR）、紧密连接蛋白的表达;②蛋白印记（WB）检测两组患儿肠黏膜上皮细胞中p38丝裂原活化蛋白酶（p38MAPK）以及磷酸化p38MAPK （p-p38MAPK）的表达;③酶联免疫吸附测定法（ ELIA）检测术前以及术后7 d 血清中的血清肿瘤坏死因子 α （TNF-α）含量.结果 治疗组患儿A2BAR灰度值（139.33 ±34.06）低于对照组（177.60 ±11.58,P＜0.01）;治疗组患儿Occludin蛋白灰度值（198.63 ±14.23）高于对照组（175.64 ±18.17,P＜0.01）;与对照组比较,治疗组患儿的p38MAPK表达比较差异未见统计学意义（P＞0.05）,p-p38MAPK的表达升高,差异有统计学意义（P＜0.05）;术前治疗组患儿TNF-α浓度为（95.30 ±9.39）pg/ml,高于对照组的（70.57 ±5.84）pg/ml（P＜0.05）;治疗后7 d治疗组患儿TNF-α浓度与对照组比较差异未见统计学意义（P＞0.05）.结论 小儿急性肠梗阻肠坏死导致缺血缺氧,促进了细胞的凋亡及TNF-α释放,造成A2BAR表达量增多,紧密连接蛋白表达下降,这可能是导致肠道细菌移位的原因.Objective To investigate the expression of adenosine A 2B receptor and tight junc-tion protein Occludin in children with acute intestinal obstruction necrosis and its clinical significance . Methods A total of 30 children with acute intestinal obstruction necrosis were selected as the treatment group, and 30 children with digestive tract malformation were selected as the control group , the two groups underwent bowel resection and bowel anastomosis.Detection method：①Immunohistochemicstry was used to detect the expression of intestinal epithelial cells adenosine A 2B receptor and Occludin.②Western Blot was used to detect the expression of intestinal epithelial cells p 38MAPK and p-p38MAPK.③ELISA was used to detect the concentration of serum TNF-αin serm before and 7 days after surgery.Results The positive intensity of A2BR in treatment group （139.33 ±34.06） was signifi-cantly lower than that in control group （177.60 ±11.58, P〈0.01）; the positive intensity of Occludin protein in treatment group （ 198.63 ±14.23 ） was significantly higher than that in control group （175.64 ±18.17,P〈0.01）; there was no significant difference in p38MAPK expression between con-trol group and treatment group （P〉0.05）.The expression of p-p38mapk in treatment group was signifi-cantly higher than that in control group , and the difference was significant （P〈0.05）; the preoperative concentration of serum TNF-αof treatment group was （95.30 ±9.39 ） pg/ml, which was significantly higher than that of control group [（70.57 ±5.84）pg/ml, P〈0.05]; the concentration of serum TNF-α of treatment group at 7 days after the operation had no significant difference with the control group （ P〉0.05）.Conclusions Intestinal necrosis in children with acute intestinal obstruction leads to ischemia and hypoxia, results in increase in A2BR expression and decrease in occludin expression , which may be the cause of intestinal bacterial translation.

关 键 词：急性肠梗阻肠坏死 A2B腺苷受体 紧密连接蛋白OCCLUDIN 血清肿瘤坏死因子d p38丝裂原活化蛋白酶 α酸化p38丝裂原活化蛋白酶 

分 类 号：R725.7[医药卫生—儿科]