【作者】 钟秋娌；

【导师】 柯晓；

【作者基本信息】 福建中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：研究隆起糜烂性胃炎(Raised Erosive Gastritis,REG)脾胃湿热证与细胞因子(cytokine,CK)白介素8(Interleukin-8,IL-8)、白介素10(Interleukin-10,IL-10)、肿瘤坏死因子α(Tumor Necrosis Factor,TNF-α)表达之间的关系。方法：选择REG病例70例,按中医辨证标准分为脾胃湿热证、脾胃虚弱证两组,分别为34例、36例,同时设正常对照组13例。所有受试者均行胃镜检查,于胃镜下取胃窦部粘膜活检标本,用快速尿素酶试验及组织染色法检测幽门螺旋杆菌(Helicobacter Pylori,Hp),用免疫组织化学法检测IL-8、TNF-α、IL-10的表达量,活检标本同时行病理组织学诊断。结果：1.REG组IL-8的表达水平与正常组相比无明显差异(p>0.05)；REGHp(+)组、Hp(-)组、正常组三组间IL-8的表达水平无显著性差异(p>0.05)；REG脾胃湿热组、脾胃虚弱组IL-8的表达水平与正常组比较均有升高趋势,但其差异无统计学意义(p>0.05)；REG脾胃湿热组IL-8的表达水平与脾胃虚弱组相比无明显差异(p>0.05)；REG脾胃湿热组、脾胃虚弱组两组中Hp(+)组与Hp(-)组的IL-8表达水平无显著性差异(p>0.05)。2.REG组TNF-α的表达水平高于正常组,有显著性差异(p<0.01)；REG Hp(+)组、Hp(-)组两组TNF-α的表达水平均高于正常组,有显著性差异(p<0.05)；REG Hp(-)组TNF-α的表达水平高于Hp(+)组,有显著性差异(p<0.05)；REG脾胃湿热组、脾胃虚弱组两组TNF-α的表达水平均高于正常组,有显著性差异(p<0.05)；脾胃湿热组TNF-α的表达水平与脾胃虚弱组相比,其差异无统计学意义(p>0.05)；REG脾胃湿热组中Hp(-)组TNF-α的表达水平高于Hp(+)组,有显著性差异(p<0.05)；脾胃虚弱组Hp(+)组TNF-α的表达水平与Hp(-)组相比,无显著性差异(p>0.05)。3.REG组IL-10的表达水平高于正常组,有显著性差异(p<0.01);REG Hp(+)组、Hp(-)组两组IL-10的表达水平均高于正常组,有显著性差异(p<0.05);REG Hp(-)组IL-10的表达水平高于Hp(+)组,有显著性差异(p<0.01)；REG脾胃湿热组、脾胃虚弱组两组IL-10的表达水平均高于正常对照组,具有显著性差异(p<0.01)；脾胃湿热组、脾胃虚弱组IL-10的表达无显著性差异(p>0.05)；REG脾胃湿热组中Hp(+)组IL-10的表达水平与Hp(-)组相比,二者无显著性差异(p>0.05)；脾胃虚弱组中的Hp(-)组IL-10的表达水平高于Hp(+)组,差异有显著性意义(p<0.01)。结论：1.IL-8在REG的发生发展过程中可能不是主要的促炎因子。2.TNF-α可能在促进REG的发生发展过程中起着重要作用。3.IL-10可能在防止REG的组织损伤中起着重要作用。4. IL-8、TNF-α、IL-10在REG脾胃湿热证与脾胃虚弱证之间表达无差异。更多还原

【Abstract】 Objective:To study the relationship between the expression of IL-8,TNF-a, IL-10 and the Raised Erosive Gastritis (REG)with spleen-stomach dampness heat syndrome.Method:70 Raised Erosive Gastritis patients whoses syndromes meet with spleen stomach-dampness-heat(SSDH) and spleen deficiency(SD) accroding to TCM dialectics were selected as research subjects.There were 34 patients in spleen-stomach dampness-heat(SSDH) group,36 patients in spleen deficiency(SD) group. And 13 healthy patients were considered as the control group. All subjects accepted gastroscopy examination.We got the samples from the gastric antrum,during the gastroscopy examination;and then the samples were used to do rapid urease test, detect the existence of Hp with histological stain method,do pathologic diagnosis and detect the expression of IL-8,TNF-a and IL-10 with immunohistochemistry.Results:1 There were no difference between the Raised Erosive Gastritis group and the control group about the expression of IL-8 (p>0.05). There were no significantly difference among the Hp positive group, the Hp negative group and the control group about the expression of IL-8(p>0.05). The expression of IL-8 in the SSDH group and the SD group were both higher than the control group, but the difference was not significant (p>0.05). The expression of IL-8 in the SSDH group and the SD group have no difference(p>0.05. In the SSDH, the expression of IL-8 between the Hp negative group and the control group was not different(p>0.05),and the result was the same in the SD group.2 The expression level of TNF-a in the Raised Erosive Gastritis group was obviously higher than the control group(p<0.01),the expression level of TNF-a in the Hp positive group and the Hp negative group were both higher compared with the control group,while the Hp negative group is higher than the Hp positive group (p<0.05). Both the SSDH group and the SD group were obviously different from the control group about the expression of TNF-a (p<0.01).Though the SSDH group expressed more TNF-a than the SD group, the different was not significan(p>0.05). In the SSDH group, the expression of TNF-a in the Hp negative group was enhanced and obviously different from the Hp positive group (p<0.01).In the SD group, the expression of TNF-a between the Hp negative group and the Hp positive group was not different (p<0.01).3 The expression of IL-10 in the Raised Erosive Gastritis group was obviously higher than the control group(p<0.01).The expression of IL-10 in the Hp positive group and the Hp negative group were both higher compared with the control group,and the Hp negative group is higher than the Hp positive group (p<0.05).The expression of IL-10 in the SSDH group and the SD group was both enhanced and obviously different from the control group(p<0.01).The SSDH group expressed more IL-10 than the SD group, but the different was not significant(p>0.05). There were no difference between the SSDH group and the SD group about the expression of IL-10 (p>0.05).In the SSDH group, The expression of IL-10 was not different between the Hp positive group and the Hp negative group (p>0.05).In the SD group, the expression of IL-10 in the Hp negative group was enhanced and obviously different fome the Hp positive group(p<0.05).Conclusion:1 IL-8 may not be a major proinflammatory cytokine in the the occurrence and development of REG2 TNF-αmay play an important role in promoting the occurrence and development of REG3 IL-10 may an important role in preventing tissue from damage in the REG4 It was not different between the REG SSDH group and the REG SD group about the expression of IL-8、TNF-a and IL-10.更多还原