肠易激综合征患者血浆脑肠肽水平的变化  

Changes of Plasma Brain-gut Peptides Levels in Patients with Irritable Bowel Syndrome

作　　者：沈骏[1] 诸琦[1] 袁耀宗[1] 傅华[1] 冯国伟[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科 [2]上海交通大学医学院附属瑞金医院核医学科,200025

出　　处：《胃肠病学》2005年第5期290-292,共3页Chinese Journal of Gastroenterology

摘　　要：背景:脑肠肽作为一类具有神经递质和激素双重功能的小分子多肽,在肠易激综合征(IBS)的发病机制中起重要作用。目的:研究血管活性肠肽(VIP),神经肽Y(NPY)和神经降压素(NT)水平在IBS患者血浆中的变化及其临床意义。方法:根据RomeⅡ标准纳入IBS患者36例,其中腹泻为主型IBS(D-IBS)24例,便秘为主型IBS(C-IBS)12例,同时纳入正常对照者10名。采用放射免疫测定分别检测受试者血浆VIP、NPY和NT水平。结果:D-IBS患者血浆VIP水平显著高于正常对照组(P<0.05),而C-IBS患者血浆VIP水平与正常对照组比较无显著差异(P>0.05);D-IBS和C-IBS患者血浆NPY水平均显著低于正常对照组(P<0.05和P<0.01),其中C-IBS患者又显著低于D-IBS患者(P<0.05);D-IBS和C-IBS患者血浆NT水平均显著高于正常对照组(P<0.05),但两亚型间比较无显著差异(P>0.05)。结论:IBS患者血浆脑肠肽水平与腹泻或便秘症状有一定的联系,表现为D-IBS和C-IBS患者的血浆NT水平均显著升高,而NPY和VIP水平因IBS亚型的不同而有差异。脑肠肽作为调节胃肠运动功能和感觉功能的重要因素,可能与IBS的发生、发展有必然的内在联系。Background： Brain-gut peptides are a group of small molecular polypeptids, having dual function of neurotransmitters and hormones which play inlportant role in the pathogenesis of irritable bowel syndrome （IBS）. Aims： To investigate the changes and clinical significance of brain-gut peptides such as vasoactive intestinal peptide （VIP）, neuropeptide Y （NPY） and neurotensin （NT） in patients with IBS. Methods： Based on Rome II criteria, 36 IBS patients, including 24 diarrhea-predominant IBS （D-IBS）, 12 constipation-predominant IBS （C-IBS）, and 10 healthy subjects were enrolled in the study. The plasmal levels of VIP, NPY and NT were measured by radioimmunoassay （RIA）. Results： The plasmal level of VIP was significantly higher in D-IBS patients than that in the normal controls （P〈0.05）, but there was no significant difference between C-IBS patients and the normal controls （P〉0.05）. The plasma NPY level in both D-IBS and C-IBS patients was significantly lower than that in the normal controls （P〈0.05, P〈0.01）, and that in the C-IBS patients was significantly lower than that in the D-IBS patients. The plasma NT level in both D-IBS and C-IBS patients was significantly higher than that in the normal controls （P〈0.05）, while there was no significant difference between the two subtypes （P〉0.05）. Conclusions： Plasma brain-gut peptides levels in patients with IBS may be related to diarrhea and constipation. The plasma NT level is higher in both D-IBS and C-IBS patients than that in the normal controls, whereas there are differences of VIP and NPY in different subtypes of IBS. Brain-gut peptides act as important factors in regulating gastrointestinal motor and sensational function, which provide inevitable inner relationship of the genesis and development of IBS.

关 键 词：肠易激综合征 脑肠肽 血管活性肠肽 神经肽Y 神经降压肽 肠易激综合征(IBS) 患者血浆 P水平 脑肠肽 IBS患者 正常对照组 血浆NPY 腹泻为主型 血管活性肠肽 

分 类 号：R574.4[医药卫生—消化系统]