非糜烂性反流病患者食管黏膜SP和CGRP的表达

Expression of SP and CGRP in esophagus mucosa of nonerosive gastroesophageal reflux disease

目的观察非糜烂性反流病（NERD）和反流性食管炎（RE）患者食管黏膜内P物质（SP）和降钙素基因相关肽（CGRP）免疫反应阳性产物的表达，探讨其在NERD发病中的作用。方法选择有典型胃食管反流症状并经反流性疾病诊断问卷（RDQ）调查、PPI试验、胃镜检查及食管24hpH检测诊断为GERD患者51例，其中RE组21例，NERD酸反流阳性组（NERD^＋组）12例，NERD酸反流阴性组（NERD^-组）18例，采用免疫组化方法在显微镜下观察NERD、RE患者食管黏膜内SP、CGRP的表达，应用彩色病理图像分析软件，分析计算SP、CGRP免疫反应的阳性指数（PI），并与正常对照组10例比较。结果NERD^-组食管黏膜内SP、CGRP的PI值为96．77±31．74和24．76±29．15，明显高于NERD^＋组（73．64±31．38、9．78±10．30）、RE组（67．56±34．62、9．61±6．20）及正常对照组（59．82±46．15、8．54±12．12）（P均〈0．05）。结论SP、CGRP在NERD^-的患者食管黏膜内有明显表达，可能在食管内脏感觉中发挥着重要的作用。

Objective To evaluate the expression of substance P （SP） and caltenin gene related peptide （CGRP） in esophagueal mueosa from patients with non-erosive gastroesophageal reflux disease （NERD） and reflux esophagitis （RE） and to explore their role in the development of NERD. Methods Fifty-one patients with typical symptoms of gastroesophageal reflux disease （GERD） were evaluated with reflux disease questionnaire （RDQ）, PPI test, endoscopy and 2ghr esophageal pH monitoring. The patients were then divided into RE group （n = 21 ）, NERD group with acid refluux （NERD ^＋ , n = 12） and NERD group without acid reflux （NERD^- , n = 18） according to the evaluation results. The expression of SP and CGRP in esophagus mucosa from these patients and 10 healthy control subjects were assayed by immunohistochemistry, and the stain positive index （PI） was calculated by Color patho-image analysis software and compared. Results The PIs of SP and CGRP in NERD^- group were 96.77 ± 31.74 and 24. 76 ± 29. 15, respectively, which were significantly higher than those of NERD ^＋ group （73.64 ± 31.38, 9. 78 ± 10. 30, respectively, P 〈 0. 05）, RE group （67. 56 ± 34. 62, 9.61± 6. 20, respectively, P 〈 0.05 ） and control group （59. 82 ± 46. 15, 8.64 ± 12. 12, respectively, P 〈0. 05）. Conclusion Expressions of SP and CGRP in esophagus mucosa from NERD patients without detectable acid reflux are significantly increased, they may play an important role in esophageal visceral sensitivity.