感染后肠易激综合征与溃疡性结肠炎缓解期患者肠黏膜细胞因子表达的相关性

Correlation between post-infective irritable bowel syndrome and cytokine expression in intestinal mucosa of patients with ulcerative colitis in remission

目的:探讨感染后肠易激综合征(PI-IBS)与溃疡性结肠炎(UC)缓解期患者结肠黏膜细胞因子表达的相关性．方法:PI-IBS组26例,UC组45例及对照组30例,结肠镜下活检降结肠和直肠黏膜标本,采用免疫组化SABC法检测其肠黏膜P物质(SP)与IL-2,IFN-γ的表达情况．结果:PI-IBS组降结肠和直肠黏膜IFN-γ和IL-2阳性率表达、SP强度均值和面积高于对照组(IFN-γ:X2=13．781,14．012,P<0．01;IL-2: X2=13．890,13．93l,P<0．01;SP强度:t=3．623, 3．722,P<0．01:SP面积:t=3．454,3．561,P< 0．01),但与UC组患者无显著差异．降结肠、直肠黏膜IFN-γ,IL-2阳性表达的PI-IBS患者,SP强度均值(t=2．202,2．220,P<0．05)、面积高于对照组(t=2．301,2．252,P<0．05),与UC组患者也无显著差异．结论:PI-IBS和UC缓解期患者细胞因子表达无显著差异．从神经-免疫机制上分析认为IBS与炎症性肠病(IBD)之间存在某种相关性,IBS可能是轻微的IBD．

AIM： To investigate whether the mucosal cytokines is differently expressed between post-infective irritable bowel syndrome （PI-IBS） and ulcerative colitis （UC） in remission. METHODS： SABC immunohistochemistry was used to detect the mucosal expression of substance P （SP）, interleukin-2 （IL-2）, and interferon-γ （IFN-γ） in 26 PI-IBS patients, 45 UC patients, and 30 controls. RESULTS： The positive rates of mucosal IFN-y, IL-2 and SP were significantly higher in the descending colon and rectum of PI-IBS patients than those in the controls （IFN-γ： χ^2 = 13.781, 14.012, P 〈 0.01; IL-2：χ^2 = 13.890, 13.931, P 〈 0.01; SP intensity： t = 3.623, 3.722, P 〈 0.01; SP area： t = 3.454, 3.561, P 〈 0.01）, but not markedly different from those in UC patients. The SP intensity and area were also significantly higher in the IFN-γ- and IL-2-positive descending colon and rectum of PI-IBS patients than those in the controls （intensity： t = 2.202, 2.220, P 〈 0.05; area： t = 2.301, 2.252, P 〈 0.05）, but not notably different from those in UC patients. CONCLUSION： The cytokine expression has no marked difference between PI-IBS and UC. There may be some correlation between PI-IBS and inflammatory bowel disease （IBD）, and IBS is probably a low-grade IBD according to neuroimmune mechanism.