闭锁小带蛋白1和闭锁蛋白与儿童原发性胆汁反流性胃炎关系的研究
Study on the Relationship between Zonula Occludens-1 and Primary Bile Reflux Gastritis in Children

目的：探讨闭锁小带蛋白1 (zonula occludens-l, ZO-1)和闭锁蛋白(occludin)与儿童原发性胆汁反流性胃炎(Primary bile reflux gastritis, PBRG)的关系。方法：选取2016年1月至2019年1月因“腹痛、恶心、呕吐”就诊于青岛大学附属医院儿科的62名患儿作为研究对象，根据胃镜检查结果将该62例患儿分为PBRG组32例和胃黏膜未见明显异常的对照组30例，再根据胆汁反流程度将32例PBRG患儿分为I级10例，II级22例。取胃窦黏膜病变组织，采用SP免疫组织化学半定量法检测胃粘膜组织ZO-l和occludin的含量。结果：儿童PBRG组ZO-l蛋白染色结果阳性率为50% (16/32)，其水平明显低于对照组的83.3% (25/30)，差异有统计学意义(P < 0.01)，而occludin在两组中的表达差异无统计学意义(P > 0.05)。与此同时在32例儿童PBRG中，ZO-1在胆汁反流程度分级中所占的比例分别为I级90.0% (9/10)，II级31.8% (7/22)，差异有统计学意义(P < 0.05)；PBRG组和对照组中occludin的阳性表达率分别为78.1% (25/32)，86.7% (26/30)，差异无统计学意义(P > 0.05)。结论：ZO-l蛋白在儿童PBRG组中的表达较对照组明显减弱，且ZO-l蛋白的表达量与胆汁反流程度呈负相关；occludin的表达量与胆汁反流的严重程度无关。
Objective: This paper discusses the relationship between zonula occludens-l (zo-1), occludin and primary bile reflux gastritis (PBRG). Methods: A total of 62 children who were admitted to the Department of Pediatrics, the Affiliated Hospital of Qingdao University from January 2016 to January 2019 due to “abdominal pain, nausea and vomiting” were selected as the subjects. According to the results of gastroscopy, the 62 children were divided into PBRG group (n = 32) and control group (n = 30) with no obvious abnormalities in gastric mucosa. According to the degree of bile reflux, the 32 children with PBRG were divided into grade I (n = 10) and Grade II (n = 22). The contents of ZO-L and occludin in gastric mucosa were detected by SP immunohistochemical semi-quantitative method. Results: The positive rate of ZO-l protein staining in the children PBRG group was 50% (16/32), which was significantly lower than that in the control group (83.3% (25/30), and the difference was statistically significant (P < 0.01). There was no significant difference in occludin expression between the two groups (P > 0.05). Meanwhile, in 32 children with PBRG, the proportion of ZO-1 in the degree of bile reflux was 90.0% (9/10) in grade I and 31.8% (7/22) in grade II, respectively, with statistical significance (P < 0.05). The positive expression rate of occludin in PBRG group and control group was 78.1% (25/32) and 86.7% (26/30), respectively, with no statistical significance (P > 0.05). Conclusion: Compared with non-bile reflux gastritis, the expression of ZO-1 in children’s PBRG was significantly decreased, and the expression level of ZO-1 was negatively correlated with the pathological damage degree of gastric mucosa. The expression of occludin was not related to the severity of bile reflux.