摘要
目的了解迁延性腹泻病结肠黏膜患儿的内镜下特点及血清和结肠灌洗液中一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平变化及意义。方法选择2009年3月-2010年6月本科收治的迁延性腹泻病患儿115例(迁延性腹泻组)。另选择同期住院的急性腹泻病患儿115例(急性腹泻组)及体检健康儿童115例(健康对照组)作为对照。对迁延性腹泻组患儿行结肠镜检查。3组患儿均采用硝酸还原酶法测定血清NO水平,硫代巴比妥法测定MDA水平,黄嘌呤氧化酶法测定SOD水平。结果迁延性腹泻组患儿结肠镜下所见病变主要以左半结肠为主,其中43例结肠黏膜呈大小为1～2 mm疱疹样改变伴充血糜烂;52例患儿结肠黏膜糜烂水肿;12例结肠黏膜充血水肿,血管网模糊;8例未见明显异常。迁延性腹泻组结肠灌洗液中NO、MDA、SOD水平治疗前后比较差异均有统计学意义(u=10.32、6.57、4.00,Pa<0.05)。迁延性腹泻组和急性腹泻组血清NO、MDA水平比较差异均无统计学意义(u=0.85、0.78,Pa>0.05),SOD水平比较差异有统计学意义(u=57.13,P<0.01)。健康对照组血清NO、MDA、SOD水平与迁延性腹泻组(u=12.07、10.53、17.70,Pa<0.01)及急性腹泻组(u=14.70、9.79、7.33,Pa<0.05)比较差异均有统计学意义。迁延性腹泻组治疗前后血清NO、MDA、SOD水平比较差异均有统计学意义(u=7.99、6.80、12.84,Pa<0.05);急性腹泻组治疗前后血清NO、MDA、SOD水平比较差异均有统计学意义(u=11.31、6.95、8.59,Pa<0.05)。结论 NO生成所产生氧自由基及脂质过氧化反应在腹泻病的发病中发挥重要作用,并能导致结肠黏膜损害,而保护性因素(SOD)的持续降低则是腹泻病迁延不愈的重要因素。
Objective To investigate the characteristics of mucosal changes in persistent childhood diarrhea under the colonoscopy and the clinical significance and changes of serum and the colon lavage nitric oxide （ NO）, malondialdehyde （ MDA ） and superoxide dismutase （SOD） contents. Methods A total of 115 cases with persistent diarrhea from Mar. 2009 to Jun. 2010 were selected as persistent diarrhea group. One hundred and fifteen cases of other patients with acute diarrhea in the same period of hospitalization of 115 cases（ acute diarrhea group ）and 115 cases of healthy children（ healthy control group） were selected as controls. The persistent diarrhea undergoing colonoscopy, the serum NO contents were measured by the method of nitric acid reductase,and the MDA contents were measured by the method of thiobarbitu- ric acid reaction （TBA）, while the SOD contents were measured by xanthine oxidase method. Results The patients undgoing colonoscopy showed abnormality especially in the left half colon, and the colonic mucosa of 1 - 2 mm size of herpetiformis changed with congestion erosion happened among the 43 cases ;The edema and the erosion of the colonic mucosa happened among the 52 cases ;The hyperemia and the edema of the colonic mucosa and the vascular network showed indistinctly among the 12 cases;there were 8 normal cases. The levels of NO,MDA and SOD in colonic lavage fluid of deferment diarrhea group before and after treatment had no significant differences（ u = 10.32,6.57,4.00 ,Pa 〈 0.05 ）. There was no significant difference in the contents of NO and MDA between the persistent diarrhea group and the acute diarrheal disease group（ u = 0.85,0.78 ;Pa 〉 0.05 ） ,but there was significant differences in the contents of SOD（ u = 57.13 ,Pa 〈 0.01 ）. There were sig- nificant difference in the contents of NO, MDA and SOD between the healthy control group and the persistent diarrhea group （ u = 12.07, 10. 53,17.70 ;Pa 〈 0.05） or between the healthy control group and the acute diarrheal disease group （u = 14.70,9.79,7.33;Pa 〈 0.05 ）. The contents of NO, MDA, SOD in the persistent diarrhea group after therapy were different significantly compared to those before therapy（ u = 7. 99,6.80,12.84,Pa 〈 0.05 ）. The contents of NO,MDA,SOD in the acute diarrheal disease group were significantly different compared to those before therapy（ Pa 〈 0.05 ）. Conclusions NO production generated oxygen free radicals and lipid peroxidation play important roles in diarrheal diseases and can lead to colonic mucosal damage. It was an important factor that protective factors （SOD） continued to reduce diar- rheal diseases deferment is the important factors.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第19期1499-1501,共3页
Journal of Applied Clinical Pediatrics
