胃食管反流和支气管哮喘的相关性研究

发布时间：2018-04-30 05:33

本文选题：胃食管反流 + 哮喘　；参考：《延边大学》2012年硕士论文

【摘要】：目的：探讨胃食管反流能否导致类似哮喘样病理生理变化及发生机制方法：选择60只周龄为6-8的雄性BALB/c小鼠,采用随机分组的方法将这60只小鼠分为4组,每组小鼠为15只：A组(胃食管反流对照组)、B组(哮喘对照组)、C组(胃食管反流组)、D组(哮喘组)。C组,从第1天开始用灌胃器缓慢灌注O.1mmol/L盐酸+0.5%胃蛋白酶溶液,Ph值3,每次灌胃lml,每天一次,连续21天。D组,用新鲜配制的20μg清蛋白(ovalbumin,OVA)+1mg氢氧化铝共0.2ml于第1、8、15天腹腔注射一次致敏,第22天开始雾化吸入2%OVA生理盐水溶液,每天吸入1次,每次30分钟连续7天。A组用生理盐水进行灌胃。B组用生理盐水进行腹腔注射和雾化吸入。卵清蛋白攻击结束1周后再次给予OVA(10mg/ml)生理盐水溶液雾化吸入30分钟,与灌胃组小鼠在末次灌胃后,24小时内用组胺进行支气管激发试验,并测定每组小鼠的气道阻力变化,观察是否产生气道高反应性；进行肺泡灌洗液涂片,镜下计数肺泡灌洗液中嗜酸性粒细胞和中性粒细胞所占的百分比；采用流式细胞术测定脾脏细胞中IL-4、IFN-γ,Th1/Th2比值的变化；肺组织以及食管病理切片经HE染色后观察病理形态变化。结果：①进行气道阻力检测后,A、B组的小鼠均未发生气道高反应性,C、D组在行支气管激发试验后气道阻力比值比A、B组增高,比较差异有统计学意义(P0.05),C、D组之间比较差异无统计学意义(P0.05)。②4组小鼠IL-4值得比较,C、D组小鼠IL-4较A、B组明显增高,比较差异有统计学意义(P0.05),C、D组之间,A、B组之间比较差异均无统计学意义(P0.05)。③C、D组小鼠IFN-γ较A、B组明显降低,比较差异有统计学意义(P0.05),C、D组之间,A、B组之间比较差异无统计学意义(P0.05)。④c、D组小鼠Th1/Th2比值明显下降,与A、B组比较具有差异性,有统计学意义。C、D组之间,A、B组之间比较差异无统计学意义(P0.05)。⑤4组小鼠BALF中EOS数占细胞总数百分比比较,A、B组BALF中仅偶见单个嗜酸性粒细胞,C、D组可见大量的嗜酸性粒细胞。与A、B组相比较,C、D组中EOS数占细胞总数百分比明显增多,比坟差异均有统计学意义(P0.05)。c组与D组相比较,D组中EOS数占细胞总数百分比有所升高,但无统计差异性(P0.05)。A组、B组、C组、D组四组之间相互比较中性粒细胞百分比无统计学意义(P0.05)。⑥肺组织病理切片中可以观察到C、D组见支气管管腔变形,上皮细胞脱落,基底膜增厚,管壁周围炎性细胞浸润,周围血管水肿,炎症细胞浸润,肺泡腔变大,肺泡壁变薄。A、B组上皮细胞及纤毛完整,支气管管腔规则,周围未见炎性细胞浸润,以假复层纤毛柱状上皮细胞为主。食管病理切片可以观察到C组食管下段明显粘膜下水肿,粘膜下有炎症细胞浸润,角质亢进。A、B、D组基本正常,未见病理变化。结论：胃食管反流可以导致小鼠气道的类似哮喘样病理生理变化。
[Abstract]:Objective: to investigate whether gastroesophageal reflux can lead to the pathophysiological changes of asthmatic like and its pathogenesis. Methods: 60 male BALB/c mice aged 6-8 weeks were randomly divided into 4 groups. Each group consisted of 15 mice in group A (gastroesophageal reflux control group), group B (asthma control group), group C (gastroesophageal reflux group, group D), group C (asthma group, group C). From day 1 to day 1, O.1mmol/L hydrochloric acid 0.5% pepsin solution (Ph) was slowly infused into the stomach with a gastric perfusion of 3, once a day, continuously for 21 days. Group D was sensitized with fresh 20 渭 g albumin ovalbumin OVA) 1mg aluminum hydroxide co-0.2ml on day 1, 815 by intraperitoneal injection. On the 22nd day, 2%OVA saline solution was inhaled once a day for 30 minutes each time. Group A received intraperitoneal injection and atomization inhalation with normal saline for 7 days. Ovalbumin (ovalbumin) was given 10 mg / ml ovalbumin for 30 minutes, and histamine was used in bronchial provocation test within 24 hours after the last oral administration of ovalbumin, and the airway resistance of each group was measured. The percentage of eosinophils and neutrophils in alveolar lavage fluid was counted under microscope, and the ratio of IL-4 / IFN- 纬 -Th1 / Th2 in spleen cells was measured by flow cytometry. The pathological changes of lung and esophagus were observed by HE staining. Results the ratio of airway resistance in group C ~ (1) was higher than that in group A (P < 0.05). There was no significant difference between the two groups. The IL-4 of group P0.05. 24 mice was worth comparing the IL-4 of group C ~ (2 +) with that of group A (A) B, which was significantly higher than that of group A (B). There was no significant difference between the two groups. The level of IFN- 纬 in the P0.05Cn- 纬 group was significantly lower than that in the ANAB group, and there was no significant difference between the two groups. There was no significant difference in the ratio of Th1/Th2 between the two groups. The ratio of Th1/Th2 was significantly decreased in group P0.05. 4, and there was a significant difference between group A and group B, and there was a significant difference between group A and group A (P 0.05), and there was no significant difference in the ratio of Th1/Th2 between group D and group A (P 0.05). There was no significant difference between the two groups. There was no significant difference in the number of EOS in the BALF of the mice in group P0.05.54. There were only a few eosinophils in BALF of group A and B, and a large number of eosinophils were found in group C (P 0.05). Compared with group A B, the percentage of EOS in the total number of cells in group D was significantly higher than that in group A (P 0.05). The percentage of EOS in group D was higher than that in group D (P 0.05), and the percentage of EOS in group D was higher than that in group D (P < 0.05), and the percentage of EOS in group D was higher than that in group D. However, there was no statistical difference in the percentage of neutrophils between the four groups. There was no significant difference in the percentage of neutrophils among the four groups. In the pathological sections of lung tissue of C0. 05.6, it was observed that the lumen deformation, epithelial cells shedding and basement membrane thickening could be observed in CnD group. Infiltration of inflammatory cells around the wall, edema of blood vessels, infiltration of inflammatory cells, enlargement of alveolar lumen, intact epithelial cells and cilia of alveolar wall thinning of alveolar wall, regular bronchial lumen, no infiltration of inflammatory cells around. Pseudostratified ciliated columnar epithelial cells were the dominant. In group C, obvious submucosal edema and infiltration of inflammatory cells were observed in the lower part of esophagus, but no pathological changes were observed in group D with hyperkeratosis. Conclusion: gastroesophageal reflux can induce asthmatic-like pathophysiological changes in mouse airway.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6;R725.7

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