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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 is involved in the filling of intestinal epithelial gaps (IEG) in intestinal epithelial cells and to evaluate the role of mucus-filled IEG in local intestinal barrier function. Methods The ulcerative colitis (UC) patients and the control group were treated with AB-PAS and Muc2-labeled mucins to observe the expression of IEG and MUC. In addition, 39 patients with UC and 34 controls were analyzed by confocal endoscopy from January 2013 to December 2014. The modified Watson grading method was used to assess the local gut barrier function. Results The percentage of IEG in UC group was 27.52 (25.00,29.68), 5.33 (3.48,6.62)%, mucosal filling rate, microvessel defect rate and goblet cell ratio [M (P 25, P 75) , 17.38 (16.00,19.87), respectively. The control group was 12.27 (9.78,16.67), 0.27 (0.00,0.69) and 23.44 (20.24, 26.18) respectively. There was significant difference between the two groups (P <0.01). Epithelial microdeletion rate was negatively correlated with goblet cell ratio (r = -0.74, P <0.01). CONCLUSIONS: Local intestinal barrier dysfunction exists in UC patients. Mucous fluid fills IEG and maintains local intestinal barrier function.