探讨老化对胃黏膜防御-修复机制相关生物活性因子的影响。

选择2012年6月至12月因胃间质瘤、良性幽门梗阻、早期胃癌在复旦大学附属华东医院拟行手术治疗的36例患者为研究对象，其中中青年（20～59岁）患者14例（中青年组），老年（60～89岁）患者22例（老年组；60～69岁者8例，70～79岁者6例，80～89岁者8例）。在胃手术标本离体后，取远离病灶（距病灶≥5 cm）的新鲜正常胃窦黏膜组织，经组织学检查证实为正常黏膜或仅有浅表炎症后，TBA法测定胃黏膜组织内丙二醛（malondialdehyde, MDA）水平，Elisa法测定胃黏膜组织内表皮细胞生长因子（epidermal growth factor, EGF）、Caspase-3、Caspase-9、前列腺素（prostaglandin, PGs）E₂（prostaglandin E₂, PGE₂）、降钙素基因相关肽（calcitonin gene related peptide, CGRP）水平，并比较各年龄段各相关生物活性因子的变化。多组间比较采用Kruskal-WallisH检验，两组间比较采用Wilcoxon秩和检验。

与中青年组比较，老年组胃窦黏膜组织中MDA、EGF及Caspase-3水平的差异均无统计学意义（z=-1.785、-0.681、-0.049，均P>0.05）；而Caspase-9、PGE₂及CGRP水平均明显下降，差异均有统计学意义（z=-1.493、-1.038、-1.103，P<0.05或≤0.01）。中青年组及60～69岁、70～79岁、80～89岁老年患者胃黏膜组织中MDA及Caspase-3水平的差异均无统计学意义（H=5.004、0.686，均P>0.05）；而4组间EGF、Caspase-9、PGE₂、CGRP水平的变化则较明显，差异均有统计学意义（H=6.521、4.306、8.531、10.710，P<0.05或P=0.01）。其中80～89岁老年组胃黏膜组织中EGF、Caspase-9、PGE₂、CGRP水平均较中青年组明显下降，差异有统计学意义（z=-1.681、-1.493、-1.438、-1.103，P<0.05或≤0.01）。

胃黏膜防御-修复机制的老化可能是多因素、多环节相互作用的结果。

To investigate effect of aging on bioactive factors related to gastric mucosal defense-repair mechanisms.

Thirty-Six gastric surgery patients were enrolled, inclusion criteria included of benign gastric stromal tumors, benign pyloric obstruction and early gastric cancer. 14 subjects aged 20-59 belonged to the younger group, and 22 subjects aged 60 years or more to the elderly group. In the elderly group, 8 patients were aged from 60 to 69, 6 ones from 70 to 79 and 8 ones from 80 to 89 years. Fresh mucosal samples were taken from the greater curvature of the gastric antrum (distance lesions≥5 cm). After histopathological examination, specimens that were normal or had superficial inflammation were included in the study. The content of MDA in gastric antral mucosa was determined by TBA method, and that of EGF, Caspase-3, Caspase-9, PGE₂, CGRP by ELISA. Kruskal-Wallis H test was used to compare the differences between the groups. The Wilcoxon rank sum test was used to compare the results between two groups.

Compared with the younger group, the gastric mucosal content of MDA(z=-1.785,P>0.05), EGF(z=-0.681,P>0.05), Caspase-3 (z=-0.049,P>0.05) had no difference in the elderly group,while the gastric mucosal content of Caspase-9 (z=-1.493,P=0.01), PGE₂(z=-1.038,P<0.05) , CGRP(z=-1.103,P<0.01) significantly reduced in the elderly group. The gastric mucosal content of MDA(H=5.004,P>0.05) and Caspase-3 (H=0.686,P>0.05) were no difference with aging. The gastric mucosal content of EGF(H=6.521,P<0.05), Caspase-9 (H=4.306, P<0.05), PGE₂(H=8.531,P=0.01), CGRP(H=10.710, P<0.05) were significantly reduced with aging.

With aging, gastric mucosal defense-repair mechanisms were deteriorated as a result of multi-factorial interactions with several interlinks.