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山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (8): 6-13.doi: 10.6040/j.issn.1671-7554.0.2013.764

• 基础医学 • 上一篇    下一篇

共聚焦激光显微内镜在体评估NSAIDs相关胃病及其药物干预效果

王晗1, 石莎1,2, 陈飞雪1, 李月月1, 曹静1, 左秀丽1, 李延青1   

  1. 1. 山东大学齐鲁医院消化内科, 山东 济南 250012;
    2. 聊城市人民医院消化内科, 山东 聊城 252002
  • 收稿日期:2013-12-23 修回日期:2014-07-02 出版日期:2014-08-10 发布日期:2014-08-10
  • 通讯作者: 左秀丽。E-mail:xiulizuo@gmail.com E-mail:xiulizuo@gmail.com
  • 基金资助:
    国家自然科学基金资助项目(NSFC81170352、NSFC81270457)

Evaluation of NSAIDs-induced gastropathy and therapeutic effect by confocal laser endomicroscopy

WANG Han1, SHI Sha1,2, CHEN Feixue1, LI Yueyue1, CAO Jing1, ZUO Xiuli1, LI Yanqing1   

  1. 1. Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Gastroenterology, Liaocheng People's Hospital, Taishan Medical University, Liaocheng 252002, Shandong, China
  • Received:2013-12-23 Revised:2014-07-02 Online:2014-08-10 Published:2014-08-10

摘要: 目的 应用共聚焦激光显微内镜(CLE)在体评价非甾体抗炎药(NSAIDs)相关胃病中黏膜屏障功能障碍,探索替普瑞酮和雷贝拉唑对急性胃黏膜损伤预防与治疗的作用机制。方法 建立CLE急性胃黏膜损伤评分系统,在体评价NSAIDs相关急性胃黏膜损伤及药物干预效果,测定胃黏膜中occludin及ZO-1的表达水平。结果 NSAIDs相关胃病模型组黏膜损伤评分明显高于正常组,ZO-1与occludin表达明显减少。而药物预防组与治疗组损伤评分均明显降低,紧密连接蛋白表达则明显增多。结论 CLE可以客观、实时、准确地评价NSAIDs相关胃黏膜损伤中黏膜上皮细胞损伤及黏膜通透性的改变。NSAIDs可以引起occludin和ZO-1表达缺失,导致黏膜屏障功能障碍,替普瑞酮和雷贝拉唑可以通过抑制occludin和ZO-1的表达缺失,从而改善黏膜屏障功能。

关键词: NSAIDs相关胃黏膜损伤, 黏膜屏障功能障碍, 替普瑞酮, 共聚焦激光显微内镜, 雷贝拉唑

Abstract: Objective To explore the morphological nature and exact mechanisms of gastric mucosal barrier dysfunction underlying NSAIDs-related gastric damage by using confocal laser endomicroscopy (CLE), and to investigate how acute mucosal injuries were influenced by geranylgeranylacetone and rabeprazole. Methods After a 4-grade score system of acute gastric mucosal injury by CLE was established, the severity of NSAIDs-induced gastropathy and effect of medication were evaluated. The expressions of occludin and ZO-1 were detected. Results The CLE score was significantly increased and expression of tight junctions was down-regulated after the administration of indomethacin. Geranylgeranylacetone and rabeprazole could intervene in the damage process and protect the integrity of the epithelial barrier. Conclusion CLE can be objective, real-time and accurate in assessing the severity of NSAIDs-induced gastropathy. Geranylgeranylacetone and rabeprazole can be used as efficient prophylactic and therapeutic medications in NSAIDs-related gastropathy for their protective effect in maintaining the integrity of gastric mucosal barrier.

Key words: Confocal laser endomicroscopy, NSAIDs-induced gastropathy, Mucosal barrier dysfunction, Geranylgeranylacetone, Rabeprazole

中图分类号: 

  • R573.3
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