摘要
目的 探讨小儿急性肠套叠细菌移位及机制.方法 应用聚合酶链反应（PCR）定性检测细菌共有的16 SrRNA和大肠杆菌特异性β半乳糖苷酶基因BG;肠系膜淋巴结细菌培养;免疫组织化学方法检测组织Bcl-2、Bax的表达.结果 正常对照组全血16SrRNA、大肠杆菌BG未检出,空气灌肠复位组16SrRNA阳性率30%,BG阳性率20%;手术复位组16SrRNA阳性率50%,BG阳性率60%,肠系膜淋巴结培养阳性率为50%;肠坏死肠切除组16SrRNA阳性率60%,BG阳性率70%,肠系膜淋巴结培养阳性率为60%;与对照组相比,肠套叠手术组凋亡调控基因Bcl-2、Bax表达明显升高,Bcl-2/Bax比值变小.结论 小儿急性肠套叠应用PCR技术早期可诊断细菌移位,而肠套叠肠缺血再灌注损伤诱导Bcl-2、Bax蛋白表达,是引起肠黏膜细胞凋亡最终发生细菌移位可能的机制.
Objective To investigate bacterial translocation and its mechanism in children with intussusception; Methods Polymerase chain reaction （PCR） was performed after DNA extraction, with target β-1actosidase gene （BG） of E. coli and 16SrRNA gene of most pathogenic bacteria. Bacteria in mesenteric lymph nodes were cultured. Bcl-2 and Bax in intestinal tissue were determined by immunohistochemical assay. Results Bacteria DNA were not detected in the control group; In the air reduction group and operation reduction group, 16SrRNA were positive in 30% and 50% of the patients respectively, E. coli BG were positive in 20% and 60% respectively. In the intestine resection group, 16SrRNA was positive in 600/00 of patients, E. coli positive rates were 70%; In operation group and the intestine resection group, positive cultural rate of E. coli in mesenteric lymph nodes was 50% and 60%. Comparing with the control group, the expression of Bcl-2 and Bax were significantly elevated in intussusception-operated group, Bcl-2/Bax ratio was smaller. Conclusions Polymerase chain reaction （PCR） can detect of bacterial translocation early in children with intussusception. The expression of Bcl-2 and Bax were possibly induced by intestinal ischemia-reperfusion during intussusception, Intestinal apoptosis may eventually lead to bacterial translocation.
出处
《中华小儿外科杂志》
CSCD
北大核心
2010年第10期749-752,共4页
Chinese Journal of Pediatric Surgery
基金
山西省科技攻关项目（编号：20080311064-2）
关键词
肠套叠
细菌移位
基因
BCL-2
Intussusception
Bacterial translocation Genes, bcl-2
