溃疡性结肠炎和肠易激综合征重叠症状患者肠黏膜肥大细胞的变化

Alteration of intestinal mast cells in cases with overlap syndrome inside ulcerative colitis and irritable bowel syndrome

目的研究溃疡性结肠炎(Ulcerative colitis,UC)和肠易激综合征(Irritable bowel syndrome,IBS)患者肠活检组织肥大细胞(Mast cells,MC)的变化.方法收集我院2004年3月～8月期间UC、IBS患者以及对照组的结肠和直肠活检组织,通过免疫组化染色方法观察EC、MC数量的变化,并应用病理彩色图像分析软件进行定量分析.结果21例IBS、13例活动期UC及12例IBS(+)UC组肠黏膜MC数量增多,分别为65.4±6.6、74.3±7.6和73.1±3.9,与12例对照组(45.5±4.5)及10例IBS(-)UC组(48.7±5.0)比较有显著性差异(P＜0.01);IBS、活动期UC及IBS(+)UC组间比较差异无显著性(P＞0.05);IBS(-)UC组与对照组比较差异无显著性(P＞0.05).IBS及IBS(+)UC组以及对照组与IBS(-)UC组的阳染面积(Area)、阳染面积率(Pro-area)及平均积分光密度(IOD)比较差异均无显著性(P＞0.05);但IBS及IBS(+)UC组与对照组及IBS(-)UC组比较差异有显著性(P＜0.05).结论MC在UC及IBS发病中可能具有重要作用,在IBS(+)UC中尤其明显,在IBS(-)UC中MC变化不明显,UC不同时期的MC存在不同的影响因素.

Objective To explore the alteration of mast cells in patients with ulcerative colitis （ UC ） and irritable bowel syndrome （ IBS ）. Methods Colorectal biopsy specimens were obtained from healthy controls and patients with UC and IBS in West China Hospital from March 2004 to August 2004. Mast cells （MC） was identified by immunohistochemical methods and investigated qualitatively and quantitatively by means of computed image analysis. Results The number of mast cells with 21 IBS, 13 active UC and 12 IBS（ ＋ ）UC patients were 65.4±6.6,74.3 ±7.6 and 73. 1± 3.9, there were significant differences（ P 〈 0.05 ） compared with 12 healthy volunteers（ 45.5 ± 4.5 ） and 10 patients with IBS（ - ） UC （48.7±5.0）. There were no significant differences（ P 〉 0.05 ） between IBS and irritable bowel-like syndrome （IBIS） , IBS （ - ） UC and control groups. There were no significant differences between IBS and IBS （ ＋ ） UC groups, healthy controls and IBS （ - ） UC groups in image analysis （ P 〉 0.05 ）. Whereas, there was significant difference （ P 〈 0.05 ） among healthy controls and IBS （ ＋ ） UC, IBS groups. Conclusion MC might play an important role in the pathogenesis of IBS and UC, especially in IBS （ ＋ ） UC, whereas, there was not alteration of MC in IBS （ - ） UC.