功能性消化不良患者食物过敏与十二指肠肥大细胞相关性研究  

Correlation between food allergies and duodenal mast cell in patients with functional dyspepsia

作　　者：袁海鹏[1] 王晓虹[1] 李晓沛[1] 丛衍群[2] 李福康[1] 李延青[3] 

机构地区：[1]山东省泰安市中心医院消化内科,271000 [2]浙江医院消化内科 [3]山东大学齐鲁医院消化内科

出　　处：《中华消化杂志》2013年第6期371-374,共4页Chinese Journal of Digestion

摘　　要：目的 探讨食物过敏和十二指肠肥大细胞在功能性消化不良（FD）中的相关性.方法 对48例FD患者进行消化不良症状评分,其中餐后不适综合征（PDS）患者23例,上腹痛综合征（EPS）患者25例.胃镜下取48例FD患者和21名健康志愿者十二指肠球部和降段黏膜组织标本,并抽取静脉血3 mL.组织标本甲苯胺蓝染色后计数肥大细胞总数和脱颗粒肥大细胞所占百分比.ELISA法检测血清中14种食物过敏原特异性抗体IgG.两样本比较采用t检验,组间两两比较采用LSD-t检验,率的比较采用卡方检验或Fisher确切概率法,相关性采用Pearson直线相关分析.结果 十二指肠球部和降段肥大细胞数量,FD组、PDS组、EPS组均较对照组多,差异均有统计学意义（球部t=3.387、3.536、3.510,降段t=5.810、4.400、3.813;P均＜0.01）.十二指肠球部和十二指肠降段所有肥大细胞中脱颗粒肥大细胞所占百分比,FD组[（60.23±5.10）％和（66.97士5.30）％]、PDS组[（59.84±4.50）％和（66.63±5.37）％]、EPS组[（60.58±5.66）％和（67.28士5.32）％]均高于对照组[（25.38±2.32）％和（30.66±2.89）％）],差异均有统计学意义（球部t=33.639、25.496、26.563,降段t=32.513、30.521、31.612;P均＜0.05）.十二指肠球部和降段的肥大细胞数量、脱颗粒肥大细胞百分比与各症状积分均无相关性（P均＞0.05）.PDS组牛肉、蟹、虾、小麦、鸡肉的特异性抗体IgG阳性率均高于对照组,差异均有统计学意义（前4项x2=12.108、17.771、6.832、4.375,第5项为Fisher确切概率法,P均＜0.05）.EPS组牛肉、大豆、鸡肉特异性抗体IgG阳性率均高于对照组,差异均有统计学意义（前2项x2=8.915、18.600,第3项为Fisher确切概率法,P均＜0.01）.食物过敏原特异性抗体IgG阳性评分和种类,FD组、PDS组、EPS组均高于对照组,差异均有统计学意义（IgG阳性评分t=14.988、4.062、3.693,IgG阳性种类t=8.805、4.177、3.388;P均＜0.Objective To explore the correlation between food allergies and duodenal mast cells in pathogenesis with functional dyspepsia （FD）.Methods The symptoms of FD were scored in 48 patients with FD,which included 23 patients with postprandial distress syndrome （PDS） and 25 patients with epigastric pain syndrome （EPS）.The specimens of duodenal and descending part of duodenum mucosa were obtained under gastroscopy in 48 FD patients and 21 healthy volunteers,and 3 mL venous blood was taken at same time.The percentages of mast cells and degranulated mast cells were calculated after the specimens were stained by toluidine blue.The serum specific IgG antibodies of 14 food allergies were detected by enzyme-linked immunosorbent assay.Two-sample comparison was performed by t test,LSD-t-test for groups＇ comparison,chi-square or Fisher’s exact test for rates comparison and Pearson linear correlation for correlation analysis.Results The number of mast cells in duodenal and descending part of duodenum of FD group,PDS group and EPS group was significantly higher than that of control group and the differences were statistically significant （duodenal：t =3.387,3.536 and 3.510; descending part of duodenum：t=5.810,4.400 and 3.813; all P〈0.01）.In duodenal and descending part of duodenum,the percentages of degranulated mast cells in all mast cells of FD [（60.23± 5.10）% and （66.97±5.30）%],PDS [（59.84±4.50）% and （66.63±5.37） %] and EPS [（60.58±5.66） % and （67.28±5.32） %] were all higher than those of control group [（25.38 ± 2.32%） and （30.66 ±2.89）%],and the differences were statistically significant （duodenal：t=33.639,25.496 and 26.563; descending part of duodenum：t=32.513,30.521 and 31.612; all P〈0.05）.There was no correlation between the number of mast cells,percentage of degranulated mast cells in duodenal or descending part of duodenum and the scores of symptoms （all P〉0.05）.In PDS group,the rates of positive specific IgG antibodies of beef,crab,shrimp,wh

关 键 词：消化不良 食物过敏 免疫球蛋白G 十二指肠 肥大细胞增多 

分 类 号：R57[医药卫生—消化系统]