肠易激综合征患者肠黏膜肥大细胞与P物质的相关性  

The changes of mucosal mast cells and substance P in patients with irritable bowel syndrome

作　　者：董文珠[1] 李兆申[1] 邹多武[1] 许国铭[1] 邹晓平[1] 朱爱勇[1] 尹宁[1] 龚燕芳[1] 

机构地区：[1]第二军医大学长海医院消化内科,上海200433

出　　处：《中华内科杂志》2003年第9期611-614,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金资助项目 (3 0 2 70 5 0 4)

摘　　要：目的　研究肠易激综合征 (IBS)患者肠黏膜肥大细胞 (MC)、P物质 (SP)的变化及其相互关系 ,探讨其在IBS内脏高敏感性中的可能作用和临床意义。方法　黏膜标本取自 2 2例腹泻型IBS患者、2 0例便秘型IBS患者和 19例正常人的回肠末端、回盲部、升结肠、乙状结肠 ,应用甲苯胺蓝改良染色法和免疫组织化学染色法分别对MC和SP、SP受体 (SPR)进行染色 ,并应用彩色病理图像分析软件及免疫组化分析软件进行分析 ;应用放射免疫测定法检测黏膜SP含量 ;采用石蜡连续切片观察MC与SP免疫反应阳性神经纤维、SPR免疫反应阳性细胞的关系 ;采用原位包埋法透射电镜观察MC与SP免疫反应阳性神经纤维的关系。结果　IBS患者回肠末端、回盲部、升结肠MC明显增多 (P <0 0 1) ,乙状结肠MC无明显变化 ;IBS患者MC存在显著变异 ;IBS患者肠黏膜SP免疫反应阳性纤维表达增强 (P <0 0 1) ,其含量较正常对照组显著升高 (P <0 0 1) ;SP免疫反应阳性纤维与MC靠近或毗邻 ,有些存在“膜膜”接触 ,增强的阳性纤维强度、面积与MC的面积、密度密切相关 ;部分MC呈SPR免疫反应阳性。结论　MC。Objective To investigate the changes of the mast cells(MCs) and substance P(SP), and to elucidate their possible roles in visceral hypersensitivity in patients with irritable bowel syndrome (IBS) Methods In 22 diarrhea predominant IBS、 20 constipation predominant IBS and 19 controls, the biopsies were carried out from the terminal ileum, the ileocecal junction, the ascending colon, and the sigmoid colon The MCs and the SP ergic nerve terminals、SP receptor(SPR) cells were stained by histochemistry and immunohistochemistry respectively, and the results were investigated qualitatively and quantitatively by color image analyzer The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay The structure relation between the MCs and SP ergic terminals、SPR ergic cells were studied through an ultramicroscopy using in situ embedding technique and a light microscopic study in serial sections respectively Results The number of MCs in the terminal ileum, the ileocecal junction, and the ascending colon were significantly elevated in IBS patients( P <0 01) , and the MCs in IBS have great variations Significantly increased the SP ergic nerve terminals were found in patients with IBS of intestine compared with the control The correlation between mucosal MC and the SP ergic nerve terminals was found, and MCs were close to these terminals in lamina propria, which were demonstrated SP ergic nerve terminals Some MCs were demonstrated to be SPR positive cells Conclusions The MCs and SP of intestinal mucosa may play a central role in the gut hypersensitivity in both motor response and visceral perception in IBS

关 键 词：肠易激综合征 肠黏膜肥大细胞 P物质 相关性 临床意义 放射免疫测定法 病理生理学 

分 类 号：R574[医药卫生—消化系统]