【摘要】 目的研究梗阻性黄疸患者肠黏膜瘦素(Lp)、瘦素受体(Ob-R)表达水平与肠黏膜免疫屏障损害(CD4+、CD8+T细胞数量)的关系。方法收集2012年3月至2013年7月间因梗阻性黄疸住院手术治疗患者30例为试验组(OJ组),再根据血清总胆红素浓度分为轻度黄疸组(≤171μmol/L,OJ 1组,17例),中重度黄疸组(>171μmol/L,OJ 2组,13例);同期非黄疸患者21例为对照组。采用免疫组化法检测梗阻性黄疸患者小肠黏膜及正常小肠黏膜中Lp和Ob-R表达水平以及CD4+、CD8+T细胞数量,分析其相关性。结果梗阻性黄疸患者肠黏膜Lp和Ob-R表达水平、CD4+、CD8+T细胞的数量均低于对照组(Lp:OJ组1.63±1.25,对照组2.48±1.25,P<0.05;Ob-R:OJ组2.63±1.27,对照组3.90±1.00,P<0.05;CD4+:OJ组17.74±4.33,对照组28.33±4.53,P<0.05;CD8+:OJ组11.61±3.36;对照组15.95±3.69,P<0.05);肠黏膜Lp和Ob-R表达水平与肠黏膜CD4+、CD8+T细胞的数量呈正相关(P<0.05)。结论梗阻性黄疸患者肠黏膜Lp和Ob-R表达减少与肠黏膜CD4+、CD8+T细胞的数量减少相关,Lp可能对肠黏膜免疫屏障的稳定起一定作用。更多还原

【Abstract】 Objective To study the change of leptin, leptin receptor, CD4+, CD8+ lymphocytes in the mucosa of the small intestine of patients with obstructive jaundice, and to investigate the relationship between leptin and leptin receptor(Ob-R) and intestinal mucosal immune barrier of patients with obstruc-tive jaundice. Methods Thirty patients diagnosed as obstructive jaundice in Department of Hepatobiliary Surgery from March 2012 to July 2013 were selected as experimental group. The experimental group were divided into mild jaundice group(≤171 μmol/L, OJ1 group, 17 cases), and moderate to severe jaundice group(>171 μmol/L, OJ2 group, 13 cases). Twenty-one patients during the same period without obstruc-tive jaundice were selected as negative controls. Immunohistochemistry was performed in detecting the ex-pression of leptin, OB-R and CD4+, CD8+ lymphocytes in all patients. Results The expression of leptin,leptin receptor, CD4+ and CD8+ lymphocytes in experimental group were lower than the control group(Lp1.63±1.25 vs 2.48±1.25; Ob-R 2.63±1.27 vs 3.90±1.00; CD4+ 17.74±4.33 vs 28.33±4.53; CD8+ 11.61±3.36 vs 15.95±3.69; all P <0.05). There was negative correlation between bilirubin and leptin, OB-R,CD4+ and CD8+ lymphocytes; there was positive correlation between leptin, OB-R and CD4+ and CD8+lymphocytes. Conclusions The expression of leptin, OB-R, CD4+ and CD8+ lymphocytes are declined in intestinal mucosa of patients with obstructive jaundice. Leptin may exert positive effects in intestinal mucosal immune barrier with obstructive jaundice.更多还原