水通道蛋白4在慢传输型便秘患者结肠黏膜的表达和意义

Expression and significance of aquaporin 4 in the colonic mucosa of patients with slow transit constipation

目的 探讨水通道蛋白4（AQP4）与慢传输型便秘（STC）发生的关系.方法 采用免疫组织化学（免疫组化）染色法检测45例STC患者升结肠黏膜AQP4的表达.采用少量钡餐法测定胃肠道通过时间;按Bristol标准进行大便分型.比较手术前后胃肠道通过时间及大便分型情况.结果 45例STC患者结肠黏膜中AQP4高表达者36例（高表达组）,低表达者9例（低表达组）.两组患者术前大便干结者（Ⅰ型和Ⅱ型大便）分别有30例（83.3%）和3例（3/9）,差异有统计学意义（P＜0.01）;术后高表达组大便干结消失,低表达组则仍有1例患者大便干结.两组患者胃肠道通过时间术前分别为（127.3±28.2）h和（64.2±12.9）h,术后分别为（17.3±7.0）h和（28.0±12.6）h;两组术前和术后胃肠道通过时间差异以及每组手术前后差异均有统计学意义（均P＜0.01）.结论 结肠黏膜中AQP4的高表达加速了水分的吸收,可能是STC发生发展过程中的重要事件之一.

Objective To explore the relationship between the expression of aquaporin 4 （AQP4） and slow transit constipation（STC）. Methods The expression of AQP4 in the ascending colon mucosa of 45 patients with STC was detected by immunohistochemistry. The transit time of stool was measured with barium sulfate suspensions. Stool was classified using Bristol stool chart. The difference between the pre- and post-operation groups was analyzed. Results Of 45 STC patients, 36 had high AQP4 expression （high expression group） and 9 had low AQP4 expression （low expression group）.Preoperatively 30 （83.3%） patients in the high expression group and 3 （3/9） patients in the low expression group presented dry and hard stool （type Ⅰ or Ⅱ ）（P〈0.01）. Postoperatively, stool pattern was improved in all the patients of high expression group. One patient in low expression group still presented dry and hard stool （P〈0.01）. Preoperatively the transit time was （127.3±28.2） h in high expression group and （64.2±12.9） h in low expression group（P〈0.01 ）. Postoperatively, the transit time was （17.3±7.0）h in high expression group and （28.0 ±12.6）h in low expression groups（P〈0.01）.Conclusion High expression of AQP4 accelerates the water absorption in colon mucosa and may be one of the crucial events in the development of STC.