缺血性结肠炎20例临床及内镜特点分析

1994—2003年我院消化内科共收治缺血性结肠炎20例。现将其临床特点、结肠镜检查和病理资料分析如下。     

酪酸梭菌对非酒精性脂肪性肝病的疗效及对肠屏障的影响

目的探讨酪酸梭菌对非酒精性脂肪性肝病(NAFLD)患者肠屏障的作用及其对NAFLD的疗效和作用机制。方法选择在该院消化科就诊的NAFLD患者100例纳入NAFLD组,另选取50例健康体检者纳入对照组,比较两组的肠屏障功能指标[血清内毒素、二胺氧化酶(DAO)和D-乳酸]。将NAFLD组患者按照随机数字表法又分为A组、B组,两组均予以常规低脂饮食+有氧运动+双环醇1粒tid po,A组在此基础上,予以酪酸梭菌2粒tid po。将NAFLD组根据丙氨酸氨基转移酶(ALT)值分为ALT升高组和ALT正常组,比较两组肠屏障功能障碍发生率及炎性反应指标[白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)]水平。分别于给药1个月后复查患者肠屏障功能、血脂[三酰甘油(TG)、总胆固醇(TC)]、肝功能、炎性反应指标等,并对A组与B组患者以上指标进行比较。结果NAFLD组的血清内毒素、DAO、D-乳酸水平均高于对照组,差异有统计学意义(P<0.05)。ALT升高组的TNF-α、IL-6水平明显高于ALT正常组,差异有统计学意义(P<0.05)。用药后A组与B组内毒素、D-乳酸、DAO水平均较用药前下降,A组下降比B组更明显,差异有统计学意义(P<0.05)。用药后A组与B组IL-6、TNF-α、TG水平均较用药前下降,A组下降比B组更明显,差异有统计学意义(P<0.05)。A组的总有效率(86.0%)高于B组(70.0%),差异有统计学意义(P<0.05)。结论NAFLD患者存在肠屏障损伤,可能与炎性反应激活有关。联合酪酸梭菌治疗有助于改善NAFLD患者的肠屏障功能,降低血脂水平,提高疗效。     

基质细胞衍生因子/趋化因子受体4轴参与胰腺癌细胞侵袭的体外实验研究

Objective To investigate the expression of chemokine receptor (CXCR)4 in human pancreatic cancer cell lines,and its association with proliferation,adhesion and invasion of pancreatic cancer cells.Methods The CXCR4 mRNA and protein in three pancreatic cancer cell lines were detected by RT-PCR and Western blotting,respectively.Confocal microscopy was used to detect the fluorescence intensity induced by SDF-lα in AsPC-1 cells.MTT test was performed to study the proliferation of pancreatic cancer cells.The invasive ability of pancreatic cell lines was determined by transwell invasion assay kit and the adhesive ability was detected by cell adhesive test in vitro.Results There were expressions of CXCR4 mRNA and protein in different extent in three pancreatic cancer cell lines.The strong expression was seen in AsPC-1 cell line,but weak expression in SW1990 cell line.The CXCR4 was functional expressed on AsPC-1 ceils.SDF-1α improved the proliferation,adhesion and invasion of three pancreatic cancer cell lines,especially in AsPC-1 cell line,while the proliferation in SW1990 cell line was weak.But all above effects of the SDF-1α could be inhibited by AMD3100.Conclasions CXCR4 mRNA and protein were expressed in pancreatic cancer cell lines.The efficacy that SDF-1 can increase the invasive ability of pancreatic cancer ceils through SDF-1/CXCR4 axis is closely related to the expression of CXCR4.     

基质细胞衍生因子/趋化因子受体4轴参与胰腺癌细胞侵袭的体外实验研究

Objective To investigate the expression of chemokine receptor (CXCR)4 in human pancreatic cancer cell lines,and its association with proliferation,adhesion and invasion of pancreatic cancer cells.Methods The CXCR4 mRNA and protein in three pancreatic cancer cell lines were detected by RT-PCR and Western blotting,respectively.Confocal microscopy was used to detect the fluorescence intensity induced by SDF-lα in AsPC-1 cells.MTT test was performed to study the proliferation of pancreatic cancer cells.The invasive ability of pancreatic cell lines was determined by transwell invasion assay kit and the adhesive ability was detected by cell adhesive test in vitro.Results There were expressions of CXCR4 mRNA and protein in different extent in three pancreatic cancer cell lines.The strong expression was seen in AsPC-1 cell line,but weak expression in SW1990 cell line.The CXCR4 was functional expressed on AsPC-1 ceils.SDF-1α improved the proliferation,adhesion and invasion of three pancreatic cancer cell lines,especially in AsPC-1 cell line,while the proliferation in SW1990 cell line was weak.But all above effects of the SDF-1α could be inhibited by AMD3100.Conclasions CXCR4 mRNA and protein were expressed in pancreatic cancer cell lines.The efficacy that SDF-1 can increase the invasive ability of pancreatic cancer ceils through SDF-1/CXCR4 axis is closely related to the expression of CXCR4.     

胃嗜酸性肉芽肿48例病因探讨

目的　探讨胃嗜酸性肉芽肿 (GEG)的可能的发病原因。方法　回顾分析 48例GEG的临床表现及病理特点 ;采用改良Giemsa法检测幽门螺杆菌 (Hp)。结果　GEG有明显的性别差异 ,术前误诊率高 ,68 8%病变组织中有淋巴滤泡 ,Hp阳性检出率 69 6% ,周围血中 11例嗜酸性白细胞增高。结论　Hp感染、性激素水平及过敏反应有可能与GEG发病有关     

腹泻型肠易激综合征患者肠屏障功能的治疗研究

目的探讨肠屏障功能在腹泻型肠易激综合征(D-IBS)的作用和评价谷氨酰胺联合酪酸梭菌(米雅)的治疗效果。方法选择2016年1月至2017年12月该院消化科D-IBS患者240例(D-IBS组),另选100例健康对照者(健康对照组),检测2组研究对象的血清肠黏膜屏障功能指标,包括血内毒素、D-乳酸、二胺氧化酶活性(DAO)水平,同时检测炎性指标,包括C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)。将240例D-IBS患者随机分为3组,每组80例,分别为谷氨酰胺组(复方谷氨酰胺500mg,口服,每天3次)、酪酸梭菌组(米雅2粒,口服,每天3次),联合治疗组(复方谷氨酰胺500mg,口服,每天3次+米雅2粒,口服,每天3次)。用药1个月后检测D-IBS组患者3个亚组肠黏膜屏障功能指标、炎性指标并记录临床症状(腹痛、腹胀、腹泻次数等)。结果 D-IBS组患者血清内毒素、D-乳酸、DAO水平均明显高于健康对照组(P0.05)。3个亚组经治疗1个月后内毒素、D-乳酸、DAO水平均明显下降,与治疗前比较差异有统计学意义(P0.05);组间比较显示联合治疗组优于另外2个组(P0.05),单一用药的2个组之间比较差异无统计学意义(P0.05);3个亚组治疗后CRP、IL-6、IL-1β均较治疗前下降,差异有统计学意义(P0.05);谷氨酰胺组与酪酸梭菌组之间差异有统计学意义(P0.05);谷氨酰胺组与联合治疗组之间差异无统计学意义(P0.05)。3个亚组的症状均有明显改善,治疗总有效率分别为联合治疗组95%,谷氨酰胺组86.1%,酪酸梭菌组84.8%,联合治疗组明显高于其他2个组,差异有统计学意义(P0.05)。相关性分析显示疗效与肠黏膜屏障指标呈正相关关系。3个亚组均无严重的不良反应。结论 D-IBS患者存在肠黏膜屏障功能受损。谷氨酰胺、酪酸梭菌可通过改善黏膜通透性、修复黏膜屏障,有效改善症状,且联合治疗的效果最佳。     

基质细胞衍生因子/趋化因子受体4轴参与胰腺癌细胞侵袭的体外实验研究

Objective To investigate the expression of chemokine receptor (CXCR)4 in human pancreatic cancer cell lines,and its association with proliferation,adhesion and invasion of pancreatic cancer cells.Methods The CXCR4 mRNA and protein in three pancreatic cancer cell lines were detected by RT-PCR and Western blotting,respectively.Confocal microscopy was used to detect the fluorescence intensity induced by SDF-lα in AsPC-1 cells.MTT test was performed to study the proliferation of pancreatic cancer cells.The invasive ability of pancreatic cell lines was determined by transwell invasion assay kit and the adhesive ability was detected by cell adhesive test in vitro.Results There were expressions of CXCR4 mRNA and protein in different extent in three pancreatic cancer cell lines.The strong expression was seen in AsPC-1 cell line,but weak expression in SW1990 cell line.The CXCR4 was functional expressed on AsPC-1 ceils.SDF-1α improved the proliferation,adhesion and invasion of three pancreatic cancer cell lines,especially in AsPC-1 cell line,while the proliferation in SW1990 cell line was weak.But all above effects of the SDF-1α could be inhibited by AMD3100.Conclasions CXCR4 mRNA and protein were expressed in pancreatic cancer cell lines.The efficacy that SDF-1 can increase the invasive ability of pancreatic cancer ceils through SDF-1/CXCR4 axis is closely related to the expression of CXCR4.     

基质细胞衍生因子/趋化因子受体4轴参与胰腺癌细胞侵袭的体外实验研究

Objective To investigate the expression of chemokine receptor (CXCR)4 in human pancreatic cancer cell lines,and its association with proliferation,adhesion and invasion of pancreatic cancer cells.Methods The CXCR4 mRNA and protein in three pancreatic cancer cell lines were detected by RT-PCR and Western blotting,respectively.Confocal microscopy was used to detect the fluorescence intensity induced by SDF-lα in AsPC-1 cells.MTT test was performed to study the proliferation of pancreatic cancer cells.The invasive ability of pancreatic cell lines was determined by transwell invasion assay kit and the adhesive ability was detected by cell adhesive test in vitro.Results There were expressions of CXCR4 mRNA and protein in different extent in three pancreatic cancer cell lines.The strong expression was seen in AsPC-1 cell line,but weak expression in SW1990 cell line.The CXCR4 was functional expressed on AsPC-1 ceils.SDF-1α improved the proliferation,adhesion and invasion of three pancreatic cancer cell lines,especially in AsPC-1 cell line,while the proliferation in SW1990 cell line was weak.But all above effects of the SDF-1α could be inhibited by AMD3100.Conclasions CXCR4 mRNA and protein were expressed in pancreatic cancer cell lines.The efficacy that SDF-1 can increase the invasive ability of pancreatic cancer ceils through SDF-1/CXCR4 axis is closely related to the expression of CXCR4.     

幽门螺杆菌相关胃粘膜病变的免疫致病机制

幽门螺杆菌感染与胃粘膜病变关系密切。免疫反应在幽门螺杆菌致病机制中可能起重要作用。本文就近年来幽门螺杆菌相关胃粘膜病变的免疫学研究作一综述。     

老年男性非酒精性脂肪肝和代谢综合征的关系

目的探讨老年男性人群中非酒精性脂肪肝和代谢综合征的关系。方法选取2012年1月至9月在中山医院青浦分院参加体检的男性老年人910例,分别测量体质量指数（BMI）、腰围、臀围、肝功能、血脂、空腹血糖及胰岛素,询问既往饮酒史、肝炎史、药物史、高血压史及糖尿病等慢性病史。根据诊断标准分为脂肪肝组（174例）和非脂肪肝组（736例）,按照BMI分层,分析不同层次老年脂肪肝、代谢综合征发生率和代谢指标的异常情况。通过Logistic等统计方法分析脂肪肝和代谢综合征、代谢异常之间的关系。结果（1）老年男性人群中非酒精性脂肪肝的发病率为19．1％,代谢综合征的发病率为16．0％。（2）脂肪肝与非脂肪肝组年龄、BMI、舒张压、腰围、甘油三酯、高密度脂蛋白、谷草转氨酶差异有统计学意义（P〈0．01）。脂肪肝组高血压、高脂血症、糖尿病、肥胖、代谢综合征的发病率分别为63．2％、33．3％、28．7％、33．3％、70．1％,明显高于非脂肪肝组（P〈0．05）。（3）将脂肪肝组和非脂肪肝组根据BMl分层分析,两组代谢异常例数随着BMI的增加而增加,脂肪肝组患者在BMI正常时出现代谢指标异常的例数明显多于非脂肪肝组（P〈0．01）。（4）肥胖、糖尿病、高血脂、高血压、代谢综合征人群中脂肪肝的患病率分别为33．2％、27．7％、26．6％、23．8％、39．7％,患病风险分别是对照人群的4．57倍、1．82倍、1．83倍、1．48倍、3．26倍。结论在老年男性中,脂肪肝与高血压、高脂血症及肥胖等代谢异常疾病有关,可作为预示代谢综合征的危险因素。