摘要
背景:目前研究认为5-羟色胺(5-HT)参与了内脏感觉过敏的发生。已发现肠易激综合征患者肠道黏膜中分泌5-HT的肠嗜铬细胞(EC细胞)和肥大细胞有所改变。目的:研究胃感觉过敏患者近端胃黏膜5-HT阳性细胞的变化,探讨其在胃感觉过敏中的作用。方法:应用电子恒压器测定40例功能性消化不良(FD)患者和15名正常对照者的胃感觉阈值,根据胃感知阈值将23例行胃镜活检组织病理学检查的FD患者分为感觉过敏(FD-H)组和感觉正常(FD-N)组。以免疫组化方法检测近端胃黏膜5-HT阳性细胞,应用图像分析系统测定其积分光密度(IOD)值。结果:FD组的胃感知、不适和疼痛阈值均较正常对照组显著下降。FD-H组近端胃黏膜每高倍视野下5-HT阳性细胞数显著多于FD-N组和正常对照组(14.1±2.3对8.7±1.9和8.3±1.4,P<0.05)。扩张刺激后,FD-H组5-HT阳性细胞IOD值的降幅(反映介质释放量)较FD-N组和正常对照组显著增加(16.3%±3.4%对10.7%±2.2%和8.1%±2.3%,P<0.05)。直线相关分析显示,5-HT阳性细胞释放介质越多,胃感知阈值越低。结论:部分FD患者存在胃感觉过敏,与近端胃黏膜5-HT阳性细胞数量增多、介质释放增加有关。
Background： Recent studies demonstrated that 5-hydroxytryptamine （5-HT） was involved in the genesis of visceral hypersensitivity. Several studies reported that there were alterations of enterochromaffin cells and mast cells in the intestinal mucosa of patients with irritable bowel syndrome. Aims： To investigate the changes of 5-HT-positive cells in proximal gastric mucosa of patients with gastric hypersensitivity, and to evaluate its role in gastric hypersensitivity. Methods： Gastric sensation thresholds were measured by barostat in 40 functional dyspepsia （FD） patients and 15 normal controls. According to gastric perception threshold, 23 FD patients undergone gastric biopsy were divided into two groups： hypersensitivity （FD-H） group and normal sensation （FD-N） group. Proximal gastric mucosal 5-HT-positive cells were examined by immunohistochemical method and their integrated optical density （IOD） value measured by image analysis. Results： Gastric perception, discomfort and pain thresholds were significantly lower in FD patients than those in the controls. The number of 5-HT-positive cells under high power field in proximal gastric mucosa of FD-H group was significantly higher than that of FD-N group and the controls （14.1±2.3 vs. 8.7±1.9 and 8.3±1.4, P〈0.05）. The percentage reduction of IOD value of 5-HT-positive cells after stimulation, which reflected the degranulation of 5-HT-positive cells, was significantly higher in FD-H group than that in FD-N group and the controls （16.3%±3.4% vs. 10.7%±2.2% and 8.1%±2.3%, P〈0.05）. Linear correlation analysis showed that the gastric perception threshold decreased in concordance with the increase of degranulation of 5-HT-positive cells. Conclusions： Gastric hypersensitivity exists in a portion of FD patients, and is associated with an increase in number and degranulation of 5-HT-positive cells in proximal gastric mucosa.
出处
《胃肠病学》
2006年第8期473-476,共4页
Chinese Journal of Gastroenterology
基金
国家自然科学基金项目(No.39840015)资助
关键词
胃
感觉过敏
血清素
肠嗜铬细胞
肥大细胞
Stomach
Hyperesthesia
Serotonin
Enterochromaffin Cells
Mast Cells
