血清GABA、BDNF、5-HT、DA及NE在胃食管反流病中的表达及临床意义  

Expression of serum GABA,BDNF,5-HT,DA,and NE in gastroesophageal reflux disease and its clinical significance

作　　者：赵倩[1] 赵艳[1] 殷燕[1] 刘亚萍[1] 和水祥[1] 任牡丹[1] 李雅睿[1] ZHAO Qian;ZHAO Yan;YIN Yan;LIU Yaping;HE Shuixiang;REN Mudan;LI Yarui(Department of Gastroenterology,the First Affiliated Hospital of Medical College of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学医学院第一附属医院消化内科,陕西西安710061

出　　处：《贵州医科大学学报》2023年第2期193-199,共7页Journal of Guizhou Medical University

基　　金：陕西省重点研发项目(2022SF-373);陕西省自然科学项目(2022JM-456)。

摘　　要：目的探讨血清γ-氨基丁酸(GABA)、脑源性营养因子(BDNF)、5-羟色胺(5-HT)、去甲肾上腺素(NE)及多巴胺(DA)在胃食管反流病(GERD)中的表达及临床意义。方法选取100例GERD患者作为GERD组、40例同期健康体检者为对照组,GERD组患者给予药物治疗8周,根据治疗效果分为效果良好组和效果不良组;对照组于体检时、GERD组于治疗前、治疗后(8周时)取外周静脉血,检测血清GABA、BDNF、5-HT、DA、NE、胃动素(MTL)、胃泌素(GAS)、胆囊收缩素(CCK)水平;采用匹兹堡睡眠质量指数(PSQI)、汉密尔顿抑郁量表(HAMD)、焦虑自评量表(SAS)、日常生活能力量表(ADL)评分评估GERD组治疗前后、对照组体检时的睡眠质量、抑郁程度、焦虑状态、日常生活能力;比较GERD患者治疗前后、效果良好及效果不良组食管括约压力、立位返流时间比、卧位反流时间比、总反流时间;采用Pearson分析GERD患者治疗前GABA、BDNF、5-HT、NE及DA水平与患者食管括约肌压力、立位返流时间比、卧位返流时间比、总返流时间比、MTL、GAS、CCK的相关性。结果GERD组治疗后血清GABA、BDNF、5-HT、NE、DA、MTL、GAS水平高于治疗前、但低于对照组,血清CCK水平及各量表评分均低于治疗前、但高于对照组(P<0.05);GERD组患者治疗后食管括约压力高于治疗前,立位返流时间比、卧位反流时间比、总反流时间均低于治疗前(P<0.05);30例疗效不良组GERD患者血清GABA、BDNF、5-HT、NE、DA、MTL、GAS水平及食管括约肌压力均低于70例疗效良好组,血清CCK水平、各量表评分、立位返流时间比、卧位反流时间比、总反流时间比均高于疗效良好组(P<0.05);GERD患者治疗前血清BDNF、5-HT、DA水平与MTL、GAS、食管括约肌压力呈正相关,与立位返流时间比、卧位反流时间比、总反流时间比、CCK呈负相关,GABA、NE与MTL、GAS、食管括约肌压力呈正相关,NE与立位返流时间比、CCK呈负相关性Objective To investigate the expression and clinical significance of serumγ-aminobutyric acid(GABA),brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine(5-HT),norepinephrine(NE)and dopamine(DA)in gastroesophageal reflux disease(GERD).Methods One hundred patients with GERD were selected as the study group,and 40 healthy subjects as the control group.The levels of serum GABA,BDNF,5-HT,DA,NE,motilin(MTL),gastrin(GAS)and cholecystokinin(CCK)in patients with GERD were compared with those before treatment,8 weeks after treatment in the study group and during physical examination in the control group,8 weeks after treatment in the effective group and the ineffective group.Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale(HAMD),Self-rating Anxiety Scale(SAS),and Activity of Daily Living Scale(ADL)were used to evaluate the sleep quality,depression,anxiety,and daily living ability of the patients in the study group before and after treatment and the control group during physical examination.Compare the esophageal sphincter pressure,standing reflux time ratio,supine reflux time ratio,and total reflux time in GERD patients before and after treatment and betueen the groups with good and bad effects.Pearson correlation coefficient was used to analyze the correlation between the levels of GABA,BDNF,5-HT,NE,and DA in GERD patients before treatment and esophageal sphincter pressure,upright reflux time ratio,supine reflux time ratio,total reflux time ratio,MTL,GAS,and CCK.Results After treatment,the levels of serum GABA,BDNF,5-HT,NE,DA,MTL and GAS in the study group were higher than those before treatment but lower than those in the control group,and the levels of serum CCK and scores of each scale were lower than those before treatment but higher than those in the control group(P<0.05).In the study group,the esophageal sphincter pressure after treatment was higher than that before treatment,and the time ratio of vertical reflux,time ratio of supine reflux and total reflux time were lower than those before tre

关 键 词：胃食管反流 Γ-氨基丁酸 脑源性营养因子 5-羟色胺 去甲肾上腺素 多巴胺 表达差异 

分 类 号：R573[医药卫生—消化系统]