溃疡性结肠炎患者肠黏膜P糖蛋白的表达及其临床意义

Expression of P-glycoprotein in the colonic mucosa of ulcerative colitis patients and its clinical significance

目的研究溃疡性结肠炎(UC)患者激素治疗前后肠黏膜上皮细胞P糖蛋白(P-GP)的表达水平以及P-GP与外周血内毒素和D-乳酸含量的相关性,探讨其与UC发病的关系。方法初治UC患者102例,健康对照者31例。采用免疫组织化学法(SP法)检测UC患者治疗前后以及健康对照者肠黏膜上皮细胞P-GP的表达水平;分别采用ELISA法和紫外分光光度计法检测UC患者治疗前后以及健康对照者外周血内毒素和D-乳酸水平。结果与健康对照组比较,治疗前UC患者外周血内毒素[(0.67±0.58)vs(18.15±0.73),P<0.01]和D-乳酸[(1.75±1.25)vs(10.85±1.94),P<0.05]水平升高,而肠黏膜上皮P-GP表达水平降低,差异均有统计学意义;接受激素治疗2个月后,UC患者肠黏膜上皮P-GP表达总阳性率和强阳性率显著高于激素治疗前水平,差异有统计学意义(P<0.05)。UC患者治疗前后外周血内毒素和D-乳酸浓度与肠黏膜P-GP表达水平呈负相关。结论UC患者肠黏膜屏障受损、通透性增加可能与肠黏膜P-GP表达水平低下有关,肠黏膜P-GP表达水平与UC发病可能具有相关性。

Objective To detect the expression of P-glycoprotein(P-GP)in the colonic mucosa of patients with ulcerative colitis(UC)before and after hormonotherapy,explore its correlation with the peripheral endotoxin and D-lactic acid levels,and investigate its association with UC.Methods Previously untreated UC patients(n=102)and healthy controls(n=31)were selected.The expression of P-GP in the colonic mucosa of UC patients before and after treatment,and that of healthy controls were detected with immunohistochemistry.The peripheral endotoxin and D-lactic acid levels were detected with ELISA and ultraviolet spectrophotometry respectively.Results Before hormonotherapy,the peripheral endotoxin[(0.67±0.58)vs(18.15±0.73),P<0.01]and D-lactic acid level[(1.75±1.25)vs(10.85±1.94),P<0.05]of UC patients were higher than those of healthy controls,while the expression of P-GP was lower(P<0.05).Two months after hormonotherapy,the total positive rate and strong positive rate of UC patients were significantly higher than the rates before therapy(P<0.05).The peripheral endotoxin and D-lactic acid levels before and after hormonotherapy were negatively correlated with P-GP expression.Conclusion The impaired intestinal barrier and increased intestinal permeability in UC patients may be related to the low expression of P-GP in intestinal mucosa.The P-GP expression may be correlated with the pathogenesis of ulcerative colitis.