本文選題：潰瘍性結(jié)腸炎 + 肝臟病變　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：潰瘍性結(jié)腸炎(ulcerative colitis,UC)是一種病因未明的慢性、反復(fù)發(fā)作的炎癥性腸病(inflammatory bowel disease,IBD),在世界范圍內(nèi),UC的發(fā)病率呈逐年升高的趨勢(shì),目前認(rèn)為UC與感染、環(huán)境、黏膜免疫功能以及機(jī)體的遺傳易感性、腸道微生態(tài)等多種因素有關(guān)。雖然UC的病變主要累及腸道,但各種形式的腸外表現(xiàn)在UC的臨床表現(xiàn)里也尤為突出,肝臟病變肝臟病變即是UC最常出現(xiàn)的腸外病變之一。目前研究推測(cè)UC時(shí),腸黏膜屏障的損傷使得腸粘膜的通透性增加,進(jìn)而使得腸道菌群通過(guò)受損的腸黏膜移位進(jìn)入血流,引起門靜脈菌血癥,并累及肝臟,使肝臟Kupffer細(xì)胞激活,并促進(jìn)Kupffer細(xì)胞生成細(xì)胞因子(如IL-6等),進(jìn)而引發(fā)炎癥的瀑布反應(yīng),損傷肝細(xì)胞,阻礙肝細(xì)胞的分泌、代謝等功能,引起肝臟病變、肝細(xì)胞損壞,導(dǎo)致肝膽疾病的發(fā)生。雙歧三聯(lián)活菌膠囊是一類聯(lián)合的菌群,是由乳酸桿菌、雙歧桿菌及糞腸球菌三者合理配比制成的,口服雙歧三聯(lián)活菌膠囊后進(jìn)入腸道可補(bǔ)充腸道的生理性細(xì)菌,并通過(guò)生理性菌群的大量繁殖,可抑制其他有害微生物的生長(zhǎng),并發(fā)揮其生物屏障的作用,使得腸道粘膜的通透性降低,并防止細(xì)菌移位,減少內(nèi)毒素的吸收和產(chǎn)生,從而減少釋放的炎癥因子的量,并進(jìn)一步使得肝功能好轉(zhuǎn)。本實(shí)驗(yàn)初步探討雙歧三聯(lián)活菌膠囊對(duì)于實(shí)驗(yàn)性結(jié)腸炎小鼠腸及肝臟的IL-6表達(dá)的影響,本實(shí)驗(yàn)將45只BALB/c小鼠隨機(jī)分為3組,分別為正常組、DSS組、DSS+雙歧三聯(lián)活菌膠囊治療組。10d后處死小鼠,去眼球取血,并取小鼠的結(jié)腸和肝臟組織,測(cè)量小鼠結(jié)腸的長(zhǎng)度,觀察各組小鼠腸及肝臟的大體形態(tài)和組織病理學(xué)改變,并用ELISA方法檢測(cè)小鼠結(jié)腸及肝臟組織IL-6的變化。實(shí)驗(yàn)結(jié)果顯示通過(guò)對(duì)實(shí)驗(yàn)性結(jié)腸炎小鼠用雙歧三聯(lián)桿菌膠囊進(jìn)行治療,DSS組小鼠的DAI評(píng)分、病理組織學(xué)評(píng)估、ELISA方法測(cè)得的小鼠結(jié)腸及肝臟組織IL-6的水平均較正常組明顯升高(P0.05)。同時(shí)DSS+雙歧三聯(lián)活菌膠囊組小鼠的DAI評(píng)分、病理組織學(xué)評(píng)估、ELISA方法測(cè)得的小鼠結(jié)腸及肝臟組織IL-6的水平均較DSS組顯著降低(P0.05)。本實(shí)驗(yàn)研究證實(shí)雙歧三聯(lián)活菌膠囊對(duì)于DSS誘導(dǎo)的小鼠實(shí)驗(yàn)性結(jié)腸炎及肝臟病變具有治療的作用,進(jìn)一步證實(shí)了雙歧三聯(lián)活菌膠囊可以調(diào)節(jié)腸道的菌群,修復(fù)腸黏膜屏障,降低腸道粘膜的通透性,從而防止細(xì)菌移位,減少內(nèi)毒素的產(chǎn)生和吸收,改善腸道與肝臟的功能,本實(shí)驗(yàn)也表明雙歧三聯(lián)活菌膠囊可下調(diào)炎癥因子的表達(dá),減輕腸黏膜及肝臟炎癥反應(yīng),有利于UC及其伴發(fā)的腸外表現(xiàn)的綜合治療,為臨床治療UC相關(guān)肝膽病變提供新的診療思路。
[Abstract]:Ulcerative colitis (UC) is a chronic, recurrent and recurrent inflammatory bowel disease (inflammatory bowel disease, IBD). In the world, the incidence of UC is increasing year by year. At present, it is considered that UC and infection, environment, mucosal immune function, genetic susceptibility to the body, intestinal microecology, etc. Although the lesions of UC are mainly involved in the intestinal tract, all forms of extraintestinal manifestations are particularly prominent in the clinical manifestations of UC. Liver pathological changes are one of the most common extraintestinal lesions that occur in UC. At present, the damage of the intestinal mucosal barrier increases the permeability of the intestinal mucosa when UC is conjectured, and the intestinal microflora may be affected by the intestinal microflora. The damaged intestinal mucosa translocation into the blood flow, cause the portal venous bacteremia, and involve the liver, activate the liver Kupffer cells, and promote the Kupffer cells to produce cytokines (such as IL-6, etc.), and then cause the waterfall reaction of the inflammation, the damage of the liver cells, the secretion of liver cells, the metabolism of liver cells, the damage of liver cells and the hepatobiliary disease. The Bifidobacterium capsule is a combined group of bacteria, which is made up of three groups of Lactobacillus, Bifidobacterium and Enterococcus faecalis. The oral Bifidobacterium capsule enters the intestine to supplement the physiological bacteria in the intestines, and can inhibit the growth of other harmful microorganisms through the large reproduction of the physiological bacteria. The effect of the biological barrier can reduce the permeability of the intestinal mucosa, prevent the bacterial translocation, reduce the absorption and production of endotoxin, reduce the amount of the inflammatory factors released, and further improve the liver function. The IL-6 expression of the Bifidobacterium bifidus Capsule on the intestines and liver of experimental colitis mice was preliminarily discussed. In this experiment, 45 BALB/c mice were randomly divided into 3 groups: normal group, DSS group, DSS+ Bifidobacterium Bifidobacterium capsule treatment group, after.10d, the mice were killed, blood was removed from the eyeball, and the colonic and liver tissues of mice were taken to measure the length of the colon, and the general morphology and histopathological changes of the intestines and liver in each group were observed, and ELI was observed. SA method was used to detect the changes of IL-6 in the colon and liver tissue of mice. The experimental results showed that the DAI score of the DSS group and the histopathological evaluation of the mice in the experimental colitis were evaluated, and the level of IL-6 in the colon and liver tissues of the mice was significantly higher than that in the normal group (P0.05), and DSS+ was observed by ELISA method (P0.05). The DAI score of mice in the Bifidobacterium capsule group was evaluated by histopathology. The level of IL-6 in the colon and liver tissues of mice measured by ELISA was significantly lower than that of the DSS group (P0.05). This experimental study confirmed the effect of Bifidobacterium Capsule on the experimental colitis and liver disease induced by DSS in mice, and further confirmed the effect. The Bifidobacterium capsule can regulate the intestinal flora, repair intestinal mucosal barrier, reduce the permeability of intestinal mucosa, prevent bacterial translocation, reduce the production and absorption of endotoxin, and improve the function of intestinal and liver. This experiment also shows that Bifidobacterium capsule can reduce the expression of inflammatory factors and reduce intestinal mucosa and liver inflammation. The disease response is beneficial to the comprehensive treatment of UC and its extra intestinal manifestations, and provides a new way of thinking for clinical treatment of UC related liver and gallbladder diseases.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R574.62

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