摘要
目的探讨小儿急性阑尾炎细菌移位的发生与阑尾组织一氧化氮合成酶（NOS）、血清一氧化氮（NO）的关系。方法应用聚合酶链反应（PCR）定性检测全血细菌DNA（所有细菌共有的16SrRNA、大肠杆菌BG）；腹腔液体及肠系膜淋巴结细菌培养；免疫组织化学方法定量检测阑尾组织NOS的表达；酶联免疫吸附试验（ELISA）定量检测不同时间血清中NO的变化。结果对照组及单纯性阑尾炎组均未检出细菌DNA，化脓性阑尾炎组16SrRNA阳性率为70％，BG阳性率为60％，肠系膜淋巴结细菌培养阳性率（大肠杆菌）为50％，腹腔液体为40％。阑尾炎组NOS平均灰度值与对照组之间有明显差异（P〈0．01）。阑尾炎组术前NO浓度与术后组、对照组间均有差异（P〈0．05）。NOS平均灰度值与NO浓度呈相关性，二者与细菌移位的表达密切相关。结论小儿急性阑尾炎发生细菌移位，而细菌移位可能与NOS、No相关，及时检测血清细菌DNA和NO对小儿急性阑尾炎细菌移位的诊治有一定的临床价值。
Objective To explore the incidence of bacterial transloeation and its relationship with appendicular nitric oxide synthase （NOS） and serum nitric oxide （NO） in children with acute ap pendicitis. Methods The presence of bacteria （16SrRNA shared by all bacteria and E. coli BG） in whole blood was detected by polymerase chain reaction （PCR）. Bacteria in peritoneal fluid and mesenteric lymph nodes were cultured. NOS in appendix was determined by immunohistochemical assay. Enzyme-linked immunosorbent assay （ELISA） was used to detect the level of NO in serum at different time points. Results Bacterial DNA was not detected in the control group or simple acute appendicitis group. In purulent group, positive rate of 16SrRNA and E. coli BG was 70% and 60%, respectively. Positive cultural rate of E. coli in mesenteric lymph nodes and peritoneal fluid was 50% and 40%, respectively. Significant difference was noted in the mean optical density of NOS staining between appendicitis groups and the control group （P〈0. 01）. The concentration of NO in pre-operative appendicitis group was significantly higher than that in the post-operative appendicitis group and the control group （P〈0. 05）. Mean optical density of NOS correlated with the concentration of NO. NOS and NO correlated closely with the expression of bacterial transloeation. Conclusions Bacterial translocation may exist in acute appendicitis in children. Bacterial translocation may correlate with NOS and NO. Detection of bacterial DNA and NO in serum is valuable in diagnosis of bacterial translocation in children with acute appendicitis.
出处
《中华小儿外科杂志》
CSCD
北大核心
2009年第7期451-454,共4页
Chinese Journal of Pediatric Surgery
基金
基金项目：山西省科技攻关项目（编号：20080311064-2）
关键词
阑尾炎
细菌移位
一氧化氮
一氧化氮合成酶
Appendicitis
Bacterial translocation
Nitric oxide
Nitric oxide synthase
