5-HT4受体激动剂对肠易激综合征患者消化间期运动及胃肠激素的影响  

Impacts of 5-HT4 receptor agonist on migrating motor complex and gastroenterological hormones of patients with irritable bowel syndrome

作　　者：王深皓[1] 董蕾[1] 李路[1] 罗金燕[1] 朱有玲[1] 王学勤[1] 郭小利[2] 

机构地区：[1]西安交通大学医学院第二附属医院,消化科,陕西西安710004 [2]西安交通大学医学院第二附属医院,感染科,陕西西安710004

出　　处：《西安交通大学学报（医学版）》2014年第2期254-257,共4页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：卫生部临床学科重点项目资助项目(No.2004-53)~~

摘　　要：目的探讨5-羟色胺4(5-HT4)受体激动剂对便秘型肠易激综合征患者(IBS-C)消化间期移行性复合运动(MMC)及血浆胃动素(MOT)、生长抑素(SS)、一氧化氮(NO)等胃肠激素有无影响。方法按照罗马Ⅲ标准招募26例IBS-C患者,同时招募28例健康对照者,对2组人进行MMC的监测,观察IBS-C患者给予5-HT4受体激动剂后MMC的变化。并且在给药前后留取MMC不同时期(Ⅰ、Ⅱ、Ⅲ期)的血液样本,对MOT、SS、NO浓度进行检测。结果①IBS-C患者给予5-HT4受体激动剂后,MMC周期显著缩短,MMCⅢ期收缩波幅均显著升高(P<0.01),MMCⅢ的传播速度加快(P<0.001)。②IBS-C患者给5-HT4受体激动剂后,血浆MOT水平显著升高(P<0.001),SS水平无显著变化(P>0.05),而NO水平显著降低(P<0.01)。③与健康人相比,IBS-C患者不同MMC时期血浆MOT浓度均显著降低(P<0.01),而SS浓度及NO浓度均显著高于健康人(P<0.001,及P<0.01)。结论上述结果为5-HT4受体激动剂治疗IBS-C的机制提供新依据,为研究IBS发病机制提供新的依据。ABSTRACT： Objective To explore the effects of 5-HT4 receptor agonist on migrating motor complex （MMC） and gastroenterological （GI） hormones such as motilin（MOT）, somatostatin （SS） and nitrogen oxide （NO） of patients with irritable bowel syndrome with constipation （IBS-C）. Methods By using 16-chanel water-perfused catheter and manometry instruments, MMC level was monitored in 26 patients with IBS-C and 28 healthy controls. After the subjects were given 5-HT4 receptor agonist, MMC was measured again and compared with them before drug administration. Blood samples of two groups were collected at MMC stages Ⅰ , Ⅱ and Ⅲ ; plasma MOT, SS and NO concentrations were detected by radio-immunity and nitrate reductase. Resolts （1） After IBS-C patients were given 5-HT4 receptor agonist, MMC durations were decreased significantly, the contraction amplitudes of stage HI were increased significantly （P〈0.01）, and the propagation velocities of stage Ⅲ were increased significantly （P〈0. 001）. （2） After treatment with 5-HT4 receptor agonist, plasma MOT levels of IBS-C patients at stages MMC Ⅰ , Ⅱ and Ⅲ were all increased significantly （P〈0. 001） while SS levels at stages MMC Ⅰ , Ⅱ and Ⅲ did not change significantly （P〈0.05）. Plasma NO levels of IBS-C patients at stages MMC Ⅰ , Ⅱ and Ⅲ were all decreased significantly （P〈0. 001）. （3） Compared with those of healthy controls, plasma MOT levels of 1BS-C patients at stages MMC Ⅰ , Ⅱ and Ⅲ were all decreased significantly （P〈0.01）. SS and NO levels at stages MMC Ⅰ , Ⅱ and Ⅲ were both increased significantly （P〈O. 001, P〈0.01）. Conclusion The results provide new basis for the mechanism of 5-HT4 receptor agonist treatment for IBS-C and the pathogenesis of IBS.

关 键 词：肠易激综合征 5-HT4受体激动剂 消化间期移行性复合运动 胃动素 生长抑素 一氧化氮 胃肠激素 

分 类 号：R574.4[医药卫生—消化系统]