肠易激综合征患者小肠黏膜5-HT信号系统的研究  

Small intestinal mucosa serotonin signal pathway in patients with irritable bowel syndrome

作　　者：王深皓[1] 董蕾[1] 李路[1] 朱有玲[1] 王学勤[1] 戴社教[1] 

机构地区：[1]西安交通大学第二附属医院消化科,710004

出　　处：《国际消化病杂志》2013年第6期415-418,共4页International Journal of Digestive Diseases

基　　金：卫生部临床学科重点项目(2004-54)

摘　　要：目的探讨肠易激综合征(IBS)患者不同部位小肠黏膜5-羟色胺(5-HT)水平及肠嗜铬细胞(EC细胞)数量是否改变。方法选取24例便秘型IBS(IBS-C)、26例腹泻型IBS(IBS-D)患者和26名健康人,行小肠镜及结肠镜检查并取十二指肠降段、近端空肠和回肠末段黏膜,用高压液相色谱-电化学法和免疫组织化学检测5-HT含量和EC细胞。结果 IBS-C患者近端空肠黏膜的5-HT含量与健康人相比有统计学意义(122±54 ng/mg蛋白比188±91 ng/mg蛋白,P<0.05),而十二指肠降段和回肠末段黏膜5-HT含量(182±90 ng/mg蛋白、61±35 ng/mg蛋白)与健康人相比(256±84 ng/mg蛋白、93±45 ng/mg蛋白)无统计学意义(P>0.05)。IBS-D患者不同部位小肠黏膜5-HT含量与健康人相比均无统计学意义(P>0.05)。IBS-C和IBS-D患者不同部位小肠黏膜EC细胞数量与健康人相比均无统计学意义(P>0.05)。结论上述结果提示IBS患者小肠黏膜5-HT信号系统异常是其发病机制之一,但是在IBS-C和IBS-D之间有差异。Objective To investigate the changes of small intestinal mucosa serotonin （5-HT） content and the number of enterochromaffin （EC） cells in patients with irritable bowel syndrome （IBS）. Methods The three study groups were patients with diarrhea-predominant IBS （IBS-D） （26 cases）, constipation-predominant IBS （IBS-C） （24 cases） and healthy controls （26 cases） who underwent endoscope examinations and whose mucosa samples at the descending part of duodenum, proximal end of jejunum and terminal ileum were obtained in the meantime. The high-performance liquid chromatography-electrochemistry （HPLC ECD） and immunohistoehemical methods were used to detect the 5-HT content and enterochromaffin cell （EC cell）. Results The small intestinal mucosa 5-HT content in IBS-C patients at the descending part of duodenum, proximal end of jejunum and terminal ileum were 182 ± 90 ng/mg protein, 122 ± 54 ng/mg protein, and 61 ± 35 ng/mg protein respectively, which were lower than those in the control group （256 ± 84 ng/mg protein, 188 ± 91 ng/mg protein, 93 -± 45 ng/mg protein）. The 5-HT content at the proximal end of jejunum had a significant difference, compared with that in the normal group （P〈 0.05）. The small intestinal mucosa 5-HT content in IBS-D patients at the above parts did not have significant differences, compared with that in the normal group （P〉0.05）. The number of EC cells in patients with IBS-C and 1BS-D did not have significant differences, compared with that in the normal group （P〉0.05）. Conclusion The changes of 5-HT signaling pathway of IBS patients may offer evidence to explain the pathogenesis of IBS, but there exist some differences between IBS-C and IBS-D.

关 键 词：肠易激综合征 小肠黏膜 5羟色胺 肠嗜铬细胞 

分 类 号：R574.4[医药卫生—消化系统]