Hp相关胃病脾胃虚实证候胃黏膜GM-CSF、RANTES表达研究

发布时间：2018-07-21 21:59

【摘要】：目的:课题组整体外周血研究提示粒细胞-巨噬细胞集落刺激因子(GM-CSF)、活化正常T细胞表达分泌调节物(RANTES)与脾胃湿热证相关;从局部胃黏膜进一步探讨其在幽门螺杆菌(Hp)相关胃病脾胃湿热证发病中的作用。方法:收集胃黏膜标本114份(包括慢性胃炎68例、消化性溃疡34例;脾胃湿热证83例、脾气虚证19例;健康受试者12名);以快速尿素酶和美兰染色进行Hp检测;HE染色评定炎性反应程度及活动度;Elivision plus定性定位检测GM-CSF、RANTES蛋白表达。结果:脾胃湿热证胃黏膜Hp感染率和程度以及炎性反应程度、活动性均较脾气虚证明显。Hp感染脾胃湿热、脾气虚证胃黏膜炎性反应程度及活动程度显著高于非感染者(P0.05)。Hp感染脾胃湿热证炎性活动度重于脾气虚证,差异具有显著性(P0.05);且胃黏膜萎缩、肠上皮化生病理改变有较脾气虚证明显的趋势。GM-CSF、RANTES蛋白表达定位于胃黏膜上皮和腺体胞浆,Hp感染尤其脾胃湿热证高于非感染者。结论:Hp可能作为引发或加重脾胃湿热证的重要原因,其促使GM-CSF和RANTE表达并参与脾胃湿热"邪正交争"的亢奋状态,引起更为严重的炎性反应及活动性程度,并可能促使胃黏膜形成萎缩及肠上皮化生的病理改变,或许这正是Hp相关胃病炎性病理改变以脾胃湿热证更为严重的原因之一。
[Abstract]:Objective: the whole peripheral blood study of our group suggested that granulocyte-macrophage colony stimulating factor (GM-CSF) and activated normal T cells expressed secretory regulator (RANTES) related to spleen and stomach damp-heat syndrome. To further explore the role of local gastric mucosa in the pathogenesis of Helicobacter pylori (HP) related gastric disease with dampness and heat of spleen and stomach. Methods: 114 gastric mucosa specimens (including 68 cases of chronic gastritis, 34 cases of peptic ulcer, 83 cases of spleen and stomach dampness and heat syndrome, 19 cases of deficiency of spleen and stomach) were collected. Rapid urease staining and methylene blue staining were used to evaluate the degree of inflammatory reaction and activity of 12 healthy subjects. The expression of RANTES protein in GM-CSF was detected by using Elivision plus. Results: the infection rate and degree of HP and the degree of inflammatory reaction in gastric mucosa of spleen and stomach dampness heat syndrome were significantly higher than those of spleen qi deficiency. The degree of inflammatory reaction and activity of gastric mucosa in deficiency of spleen syndrome was significantly higher than that in non-infected patients (P0.05) .Hp infection of spleen and stomach damp-heat syndrome was more serious than that of spleen qi deficiency syndrome (P0.05), and the gastric mucosal atrophy was significant (P0.05). The pathological changes of intestinal metaplasia showed a more obvious tendency than that of deficiency of temper syndrome. The expression of GM-CSF- RANTES protein was localized in HP infection of gastric mucosal epithelium and glandular cytoplasm, especially in damp-heat syndrome of spleen and stomach. Conclusion the expression of GM-CSF and RANTE may be the important cause of inducing or exacerbating damp-heat syndrome of spleen and stomach. It can promote the expression of GM-CSF and RANTE and participate in the hyperactive state of "evil cross competition" of dampness and heat of spleen and stomach, and cause more serious inflammatory reaction and degree of activity. The pathological changes of gastric mucosa formation and atrophy and intestinal metaplasia may be one of the more serious causes of the inflammatory pathological changes of HP related gastric diseases in the spleen and stomach dampness and heat syndrome.
【作者单位】：广州中医药大学脾胃研究所;广州中医药大学第一附属医院;
【基金】：国家自然科学基金面上项目(No.30772689,No.81373563) 中央财政支持地方高校发展专项(No.财教[2013]338号) “华南中医药协同创新中心-脾胃病、脑病创新研究团队”项目(No.2016KYTD07) 广州中医药大学“高水平大学建设”项目[No.广中医研(2016)64号]~~
【分类号】：R259

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