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肠易激综合征精神心理因素、肠黏膜肥大细胞及5-羟色胺的变化 预览 被引量:46

Changes of psychosocial factors, enteric mucosal mast cells and 5-hydroxytryptamine in irritable bowel syndrome
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摘要 目的:探讨精神心理因素、肠黏膜肥大细胞(MC)及5-羟色胺(5-HT)变化在肠易激综合征(IBS)发病机制中的作用. 方法:应用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)分别对27例IBS患者和27例对照者进行精神心理因素评分.应用免疫组化法检测回盲部肠黏膜MC含量.应用高效液相电化学检测法测定回盲部肠黏膜5-HT含量.应用直线相关分析焦虑抑郁评分、回盲部肠黏膜MC数目和脱颗粒比率、5-HT浓度之间的关系. 结果:IBS组焦虑抑郁评分HAMA(18.26±6.23)和HAMD(20.93±6.96)总分均明显高于对照组(9.15±4.91,9.89±5.31),差异有显著性(P〈0.05).IBS组回盲部肠黏膜MC数目、MC脱颗粒比率便秘型(22.1±6.5/HP,35.4%±7.1%1和腹泻型(28.4±7.3/HP和42.3%±10.1%)明显高于对照组(15.6±6.9/HP和24.8%±7.2%),差异有显著性(P〈0.05),其中腹泻型较便秘型明显升高(P〈0.05).IBS组回盲部肠黏膜5-HT浓度便秘型和腹泻型明显高于对照组(2669±920.2628±906ng/g vs 1893±984ng/g,P〈0.05),其中便秘型和腹泻型相比无显著性差异(P〉0.05).IBS患者焦虑抑郁评分与回盲部肠黏膜MC数目、MC脱颗粒比率呈正相关性(rHAMA=0.784,0.842,rHAMD=0.711,0.860,P〈0.01),与回盲部肠黏膜5-HT浓度无明显相关性(P〉0.05).IBS患者回盲部肠黏膜5-HT浓度与MC数目、MC脱颗粒比率之间无明显相关性(P〉0.05). 结论:IBS精神心理因素异常,回盲部肠黏膜MC含量及活化比例增高,5-HT浓度增高.精神心理因素异常与肠黏膜MC含量增加及肠黏膜MC的脱颗粒有关. AIM: To explore the roles of psychosocial factors, enteric mucosal mast cells (MC) and 5-hydroxytryptamine (5-HT) in the pathogenesis of irritable bowel syndrome (IBS). METHODS: Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the psychosocial status of 27 IBS patients and controls. Immunohistochemistry was used to examine the number of mucosal MC in ileocecal junction (ICJ), and the content of mucosal 5-HT in ICJ was detected by high-performance liquid chromatography (HPLC) with an electrochemical detector. The relationship among the scores of HAMA and HAMD, the number of MC and the concentration of 5-HT were analyzed. RESULTS: The scores of HAMA (18.26 ± 6.23) and HAMD (20.93 ± 6.96) in IBS patients were significantly higher than those in the controls (9.15 ± 4.91, 9.89 ± 5.31) (P 〈 0.05). The number of mucosal MC and the percentage of degranulated MC in ICJ were significantly higher in patients with constipation predominant IBS (C-IBS) (22.1 ± 6.5/HP, 35.4% ± 7.1%) and diarrheapredominant IBS (D-IBS) (28.4 ± 7.3/HP, 42.3% ± 10.1%) than those in the controls (15.6 ± 6.9/HP, 24.8% ± 7.2%) (P 〈 0.05), and they were also significantly higher in D-IBS patients than those in C-IBS patients (P 〈 0.05). The concentration of ileocecal mucosal 5-HT in C-IBS (2669 ± 920 ng/ g) and D-IBS (2628 ± 906 ng/g) patients was markedly higher than that in the controls (1893 ± 984 ng/g) (P 〈 0.05), and it was not significantly different between D-IBS and C-IBS patients (P 〉 0.05). The scores of HAMA and HAMD were positively correlated with the number of MC (r = 0.784, 0.711) and the percentage of degranulated MC (r = 0.842, 0.860) in ICJ mucosa of IBS patients (P 〈 0.01), but not with the concentration of mucosal 5-HT (P 〉 0.05). The concentration of mucosal 5-HT was not correlated with the number of mucosal MC and the percentage of degranulated MC �
作者 陈文科 邹益友 李富军 罗丹 Wen-Ke Chen, Yi-You Zou, Fu-Jun Li, Dan Luo(Department of Gastroenterology, Shenzhen Hospital of Beijing University, Shenzhen 518036, Guangdong Province, China;Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410078, Hunan Province, China ;Department of Gastroenterology, Central Hospital of Jiangmen City, Jiangraen 529030, Guangdeng Province, China)
出处 《世界华人消化杂志》 CAS 北大核心 2007年第1期46-50,共5页 World Chinese Journal of Digestology
关键词 肠易激综合征 发病机制 心理因素 肥大细胞 5-羟色胺 Irritable bowel syndrome Pathogenesis Psychosocial factors Mast cell 5-hydmxytryptamine
作者简介 陈文科,2005年中南大学湘雅医院硕士,医师. 通讯作者:邹益友.410078.湖南省长沙市.中南大学湘雅医院消化内科.zouyiyou1957@163.com电话:0731-4327106传真:0731-4327348
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