【摘要】：目的 探討大鼠在發(fā)生腸道不完全梗阻和腸管出現(xiàn)潰瘍性結腸炎（Ulcerativecolitis，UC）等遠端腸道病變后，在發(fā)病24小時（h）和1周(w)后血清中的胃動素（motilin，MTL）和膽囊收縮素（cholecystokinin,CCK）兩種胃腸激素的濃度改變情況，以及大鼠在發(fā)病后的24h和1w胃內pH值和胃粘膜的病理組織學變化。 方法 采用隨機區(qū)組法將40只大鼠分為對照組（Sham組，n=10）、不完全小腸梗阻組（Small組，，n=10）、不完全結腸梗阻組（Large組，n=10）和潰瘍性結腸炎組（UC組，n=10）。每組分別隨機選取5只大鼠于手術后24h處死，另5只于手術后1w處死。采取心臟采血的方法抽取大鼠血液并分離提取血清，通過ELISA的方法得出全部樣本的MTL和CCK的具體數(shù)值，并且在將其腹腔打開抽取胃液進行pH值測定后取大鼠的胃粘膜組織進行病理組織學分析。選用統(tǒng)計學中常用的SPSS17.0軟件進行數(shù)據(jù)分析，對于MTL和CCK的連續(xù)變量資料使用x±s表示，運用獨立樣本t檢驗的方法對MTL和CCK的數(shù)值變化進行統(tǒng)計學分析，P0.05為差異有統(tǒng)計學意義。 結果 1.與Sham組相比，其余三組在造模24h后的MTL和CCK均明顯升高，而在造模1w后兩種激素均明顯下降（均P0.05）； 2.Small組和Large組在24h和1w后的MTL和CCK均較UC組變化明顯（均P0.05）； 3.Small組和Large組的MTL和CCK在24h和1w后比較均無明顯不同（均P≥0.05）； 4.Small、Large和UC組大鼠在24h后的胃粘膜接近正常組織，而在1w后表現(xiàn)為輕度的炎性改變，按照慢性胃炎的評分標準其均表現(xiàn)為1分； 5.24h后四組兩兩比較，可見Small組和Large組的胃內pH值明顯升高（P1=0.012，P2=0.005），而UC組與Sham組相比無明顯變化（P=0.701）； 6.1w后與Sham組相比，Small、Large和UC組的胃內pH值均明顯升高（均P=0.000）,而兩兩比較發(fā)現(xiàn)三組之間的pH值無明顯差異（P1=0.121，P2=0.211，P3=0.433）。 結論 大鼠遠端腸道病變如Small、Large和UC組的MTL和CCK兩種胃腸激素在發(fā)病初期明顯升高，一周后則下降。而當大鼠遠端腸道出現(xiàn)病變后其胃內pH值會升高并且胃粘膜組織可能會出現(xiàn)一定程度的炎性改變。由此可推測遠端腸道病變不僅可引起局部發(fā)病部位的病理變化，而且還可能對上消化道甚至全身形成一定的影響。通過本次實驗的實驗結果可以推測，胃腸激素與遠端腸道病變的不同病程階段密切相關，提醒廣大臨床工作者在對遠端腸道病變時，應參考患者胃腸激素水平的情況，從而對遠端腸道病變病程的評估提供一定的依據(jù)。并且提示，當機體發(fā)生遠端腸道病變時不僅需要給予對癥治療，而且應當在胃腸激素方面給予相應的調整，還要關注上消化道甚至是全身的情況，以便做出及時的處理。
[Abstract]:Objective to investigate the serum motilin (motilin,) levels of ulcerative colitis (Ulcerativecolitis,UC) in rats after 24 hours of (h) and 1 week of (w) after the onset of incomplete intestinal obstruction and ulcerative colitis (Ulcerativecolitis,UC). The changes of gastrointestinal hormones (MTL) and cholecystokinin (cholecystokinin,CCK), and the changes of gastric pH and gastric mucosal histopathology in rats at 24 h and 1 week after the onset of the disease. Methods Forty rats were randomly divided into control group (Sham group, n = 10), incomplete small bowel obstruction group (Small group, n = 10), incomplete colonic obstruction group (Large group, n = 10) and ulcerative colitis group (UC group, n = 10). In each group, 5 rats were randomly selected to be killed 24 hours after operation and 5 rats were killed at 1 week after operation. The rat blood was taken from the heart and the serum was isolated. The specific values of MTL and CCK of all the samples were obtained by the method of ELISA. The gastric mucosal tissue of the rats was analyzed by histopathology after the gastric juice was extracted from the abdominal cavity for the determination of pH value. The data were analyzed by using SPSS17.0 software, the data of MTL and CCK were expressed by x 鹵s, and the numerical changes of MTL and CCK were analyzed by independent sample t-test. P0.05 for the difference was statistically significant. Result 1. Compared with the Sham group, the MTL and CCK of the other three groups increased significantly after 24 hours of modeling, but the two hormones decreased significantly after 1 week (P0.05). The changes of MTL and CCK in 2.Small group and Large group were significantly higher than that in UC group after 24 h and 1 week (P0.05), MTL and CCK in 3.Small group and Large group were not significantly different after 24 h and 1 week (all P > 0 05). 4. The gastric mucosa of small large group and UC group was close to normal tissue after 24 hours, but it showed mild inflammatory change after 1 week, according to the score of chronic gastritis, all rats showed 1 score. 5.After 24 hours, compared with the four groups, the intragastric pH value of Small group and Large group was significantly higher (P10.012 P2P 0.005), but that of UC group was not significantly different from that of Sham group (P0. 701). Compared with Sham group, the intragastric pH value in Small,Large and UC groups was significantly higher (P < 0. 000), but there was no significant difference in pH value between the three groups (P 1: 0. 121 P 2 0. 211 P 30.33). Conclusion Gastrointestinal hormones MTL and CCK in distal intestinal lesions such as Small,Large and UC increased at the beginning of the disease and decreased one week later. However, the pH value in the stomach increased and the gastric mucosal tissue appeared inflammatory changes after the distal intestinal lesions in rats. It can be inferred that distal intestinal lesions can not only cause pathological changes in local lesions, but also may affect the formation of upper digestive tract and even the whole body. According to the experimental results of this experiment, it can be inferred that gastrointestinal hormones are closely related to different stages of distal intestinal lesions. The majority of clinical workers should refer to the level of gastrointestinal hormones in patients with distal intestinal lesions. Therefore, it provides some basis for the evaluation of the course of distal intestinal lesions. It is suggested that when the body has distal intestinal lesions, it should not only be treated with symptomatic treatment, but also should be adjusted in terms of gastrointestinal hormones, and should pay attention to the situation of upper digestive tract and even the whole body so that timely treatment can be made.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R57

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