食物不耐受的腹泻型肠易激综合征患者肠黏膜肥大细胞与5-HT的变化及意义  

Changes of mast cells and 5-HT in intestinal mucosa of food-intolerant patients with diarrhea-irritable bowel syndrome

作　　者：唐吟菡[1] 吴萍[2] 许树长[1] 

机构地区：[1]同济大学附属同济医院消化内科,上海200065 [2]同济大学附属同济医院营养科,上海200065

出　　处：《同济大学学报（医学版）》2014年第3期25-29,36,共6页Journal of Tongji University(Medical Science)

摘　　要：目的观察食物不耐受在腹泻型肠易激综合征患者中的发生情况,分析其不同肠段黏膜肥大细胞及5-HT的变化,探讨食物不耐受在腹泻型肠易激综合征中的作用及意义。方法初筛腹泻型肠易激综合征患者,并对其进行食物特异性IgG检测及结肠镜检查,分别在回肠末端、回盲部、乙状结肠、直肠处钳取黏膜活检,进行5-HT定量及肥大细胞计数。结果腹泻型肠易激综合征患者食物不耐受阳性率为56%。根据其食物特异性IgG检测结果将受试者分为阳性组及阴性组。阳性组受试者回肠末端、回盲部、乙状结肠及直肠部位的5-HT浓度均值与阴性组同部位相比,无显著性差异。两组受试者肠黏膜5-HT的浓度均在回肠末端最高。阳性组回肠末端黏膜的肥大细胞数量明显多于阴性组(P<0.01)。阳性组回肠末端黏膜的肥大细胞数显著多于回盲部、乙状结肠及直肠等部位(P<0.01)。阴性组回肠末端黏膜肥大细胞计数与乙状结肠及直肠相比,有明显增多(P<0.05)。阳性组患者回盲部黏膜肥大细胞数量与5-HT浓度呈显著相关性。结论腹泻型IBS合并食物不耐受者肠黏膜肥大细胞数增加,且以回肠末端肥大细胞数增加更为明显。并发现该类患者肠黏膜肥大细胞数增加与5-HT浓度呈正相关。Objective To investigate the changes of mast cells and 5-HT in intestinal mucosa of foodintolerant patients with diarrhea-irritable bower syndrome（D-IBS）.Methods Twenty five patients with D-IBS were included in the study.All patients underwent food-specific IgG test and colonoscopy examination,and mucosal biopsies were taken at distal ileum,ileocecus,sigmoid colon and rectum.5-HT was measured and mast cells were counted in intestinal mucosa samples.Results Among 25patients,14 were food-intolerant（56%,positive group） and 11 were food-tolerant（negative group）according to food specific IgG test.There was no significant difference in 5-HT concentration in distal ileum,ileocecus,sigmoid colon and rectum between two groups.The mast cell count in distal ileum of positive group was significantly higher than that of negative group（P 0.01）.In positive group,the mast cells count in distal ileum was significantly higher than that in ileocecus,sigmoid colon and rectum（P 0.01）.In negative group,the mast cells count in distal ileum was higher than that in sigmoid colon and rectum（P 0.05）.In positive group,the mast cells count and the concentrations of 5-HT showed a significant correlation in ileocecus.Conclusion A increased mast cell count is found in D-IBS patients with food intolerance,especially in distal ileum.And the mast cells count and the concentrations of 5-HT in intestinal mucosa shows a positive correlation.

关 键 词：食物不耐受 肠易激综合征 食物特异性IGG 5-羟色胺 肥大细胞 

分 类 号：R154[医药卫生—营养与食品卫生学]