5-HT、IL-18、CGRP在腹泻型肠易激综合征患者中的表达及其与症状严重程度、内脏敏感度相关性的研究  

Expression of 5-HT,IL-18,and CGRP in patients with diarrheal irritable bowel syndrome and their correlation with symptom severity and visceral sensitivity

作　　者：杨露菡 刘群[2] YANG Luhan;LIU Qun(Clinical College,Wuhan University of Science and Technology,Wuhan 430081,China;Department of Gastroenterology,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]武汉科技大学临床学院,430081 [2]武汉科技大学附属天佑医院消化内科,430081

出　　处：《国际消化病杂志》2022年第3期179-184,共6页International Journal of Digestive Diseases

基　　金：湖北省自然科学基金(2014CFB818)。

摘　　要：目的探讨5-羟色胺(5-HT)、IL-18和降钙素基因相关肽(CGRP)在腹泻型肠易激综合征(IBS-D)患者中的表达及其与症状严重程度、内脏敏感度的相关性。方法选择2019年2月至2020年2月武汉科技大学附属天佑医院收治的99例IBS-D患者设为IBS-D组,另选择同期体检的99名健康人设为对照组,比较两组的血清5-HT、IL-18和CGRP水平,以及初始感觉阈值、排便阈值、疼痛阈值、内脏敏感指数(VSI),比较不同症状严重程度的IBS-D患者的血清5-HT、IL-18、CGRP水平。血清5-HT、IL-18、CGRP水平与IBS-D患者症状严重程度的关系采用Spearman相关性分析,IBS-D患者症状严重程度的影响因素采用多因素logistic回归分析,血清5-HT、IL-18、CGRP水平与内脏敏感度指标的关系采用Pearson相关性分析。结果IBS-D组的血清5-HT、IL-18、CGRP水平均高于对照组,初始感觉阈值、排便阈值、疼痛阈值均低于对照组,VSI评分高于对照组(P均<0.05);不同症状严重程度的IBS-D患者的血清5-HT、IL-18、CGRP水平均表现为重度>中度>轻度,两两比较差异均有统计学意义(P均<0.05);血清5-HT(r=0.799,P<0.001)、IL-18(r=0.512,P<0.001)、CGRP(r=0.790,P<0.001)水平与IBS-D患者症状严重程度均呈正相关;血清5-HT、IL-18、CGRP水平及VSI评分是IBS-D患者症状严重程度的危险因素,初始感觉阈值、排便阈值、疼痛阈值是IBS-D患者症状严重程度的保护因素(P均<0.05);血清5-HT、IL-18、CGRP水平与初始感觉阈值、排便阈值、疼痛阈值呈负相关,血清5-HT、IL-18、CGRP水平与VSI评分呈正相关(P均<0.05)。结论IBS-D患者的血清5-HT、IL-18、CGRP水平升高,并且其与症状严重程度、内脏敏感度有关,有望成为评估IBS-D患者症状严重程度的指标及改善内脏敏感度的靶点。Objective This paper intends to investigate the expressions of 5-hydroxytryptamine(5-HT),IL-18 and calcitonin gene-related peptide(CGRP)in patients with diarrheal irritable bowel syndrome(IBS-D)and their correlation with symptom severity and visceral sensitivity.Methods Ninetynine patients with IBS-D admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology from February 2019 to February 2020 were assigned to the IBS-D group,and 99 healthy individuals who underwent physical examination during the same period were assigned to the control group.The serum 5-HT,IL-18,and CGRP levels,as well as initial sensory threshold,defecation threshold,pain threshold,and visceral sensitivity index(VSI)score of the two groups,and the serum 5-HT,IL-18,and CGRP levels in IBS-D patients with different symptom severity were compared.The relationship between serum 5-HT,IL-18,CGRP levels and the severity of symptoms in patients with IBS-D was analyzed by Spearman correlation,and the factors affecting the severity of symptoms in patients with IBS-D were analyzed by multivariate logistic regression.The relationship between the serum 5-HT,IL-18,CGRP levels and visceral sensitivity indexes was analyzed by Pearson correlation.Results The serum 5-HT,IL-18,and CGRP levels in the IBS-D group are higher than those in the control group,the initial sensory threshold,defecation threshold and pain threshold are lower than those in the control group,and the VSI score is higher than that in the control group(P<0.05).The serum levels of 5-HT,IL-18,and CGRP IBS-D patients with different severities of symptoms are all in the order of severe>moderate>mild,and there are significant differences between pairwise comparisons(P<0.05).The serum 5-HT(r=0.799,P<0.001),IL-18(r=0.512,P<0.001),and CGRP(r=0.790,P<0.001)levels are positively correlated with the severity of symptoms in IBS-D patients.The serum 5-HT,IL-18,CGRP levels,and the VSI score are risk factors for symptom severity in patients with IBS-D while the initial sensory thres

关 键 词：5-羟色胺 IL-18 降钙素基因相关肽 腹泻型肠易激综合征 症状严重程度 内脏敏感度 

分 类 号：R574.4[医药卫生—消化系统]