结肠黏膜肥大细胞活化及外周T淋巴细胞亚群变化在肠易激综合征发病中的作用

T-lymphocytes Subgroups of Peripheral Blood and Enteromucosal Mast Cells in Patients with Irritable Bowel Syndrome

目的通过研究肠易激综合征(IBS)病人外周血T淋巴细胞亚群变化及结肠黏膜肥大细胞(MC)活化,探讨IBS与机体免疫之间的关系及MC在IBS发病机理中的作用。方法应用流式细胞术测定IBS患者T淋巴细胞亚群的比例,同时对IBS患者结肠黏膜活检组织用阿尔斯蓝染色显示黏膜内MC。结果与健康对照组比较,IBS患者CD3+、CD4+细胞数下降(P<0.05)。腹泻型IBS患者CD4+细胞数显著降低(P<0.01),CD8+细胞数显著升高(P<0.01),CD4/CD8比值下降(P<0.01)。便秘型IBS患者CD4+、CD8+细胞数均显著降低(P<0.05),但CD8+细胞抑制更明显,使CD4/CD8比值明显升高(P<0.05)。IBS患者回肠末端、回盲部、升结肠黏膜固有层MC密度较对照组明显增多(P<0.01);在同一结肠部位腹泻型IBS患者MC密度较便秘型IBS患者高(P<0.01)。结论各型IBS患者T淋巴细胞亚群比例的变化,提示IBS患者的发病与机体的免疫异常有关;IBS患者回盲部MC的增加可能与其发病机理有关。

Objective To study pathogenesis of the irritable bowel syndrome（IBS）by detecting T-lymphocytes subgroups in peripheral blood of the patients and the roles of mast cells in the pathogenesis of the IBS by determining the distribution and number of mast cells in the ileocecal and rectosigmoid junctions. Methods The flow cytometer were used to test the peripheral blood lymphocytes count and the T-lymphocytes subgroups of patients with IBS and healthy subjects. The biopsies of the terminal ileum,the ileocecal junction, the ascending colon, and the sigmoid colon were stained specifically with histochemistryfor the MC. Results The blood CD3^＋ ,CD4^＋ in IBS was lower than that in contorls（P（0.05）. The numer of mast cells in the ileocecal junction was significantly higher in patients with IBS than that in controls（P〈0. 01） ,especialy in patients with diarrhea＇predominant IBS（P〈0. 01）. Conclusion Cellular immunity abnormality may participate in pathogenesis of IBS. An increase in the number of mast cells in the ileocecal junction may be involved in the pathogenesis of IBS.