慢性浅表性胃炎脾胃湿热证胃黏膜G、D细胞变化及胃泌素、生长抑素的表达

Changes of G and D cells and expression of gastrin and somatostatin in gastric mucosa of chronic superficial gastritis with spleen-stomach dampness-heat syndrome

目的:探讨慢性浅表性胃炎脾胃湿热证患者胃黏膜G、D细胞的变化及胃泌素和生长抑素表达的意义.方法:2004-05/2005-03北京市东直门医院消化科门诊或住院的慢性浅表性胃炎患者70例,其中脾胃湿热证38例,脾胃虚弱证32例.用免疫组化的方法检测患者胃黏膜中G、D细胞的数目和胃泌素和生长抑素表达的量值.结果:与脾虚组比较,湿热组胃黏膜G细胞数目,D细胞数目,G、D细胞比值,G细胞总面积即Gas表达量,D细胞总面积即SS的表达量有显著性差异(130.54±35.62vs111.13±23.79,54.98±19.63vs67.01±21.56,2.74±1.36vs1.87±1.36,34.72±17.24vs27.72±14.23,13.90±7.22vs19.23±7.96,P<0.05或0.01).结论:G细胞增多,胃黏膜Gas增多,D细胞减少,胃黏膜SS减少,可能是湿热证的病理基础;而D细胞增多,胃黏膜SS分泌亢进,G细胞减少,胃黏膜Gas水平低下,可能是脾虚证的病理基础.

AIM： To explore the changes of G and D cells, and expression of gastrin and somatostatin in gastric mucosa of chronic superficial gastritis with spleen-stomach dampness-heat syndrome. METHODS： Seventy patients were divided into two groups： spleen-stomach dampness-heat syndrome group （n = 38） and spleen-stomach weak- ness syndrome group （n = 32）. Immunohistochemical methods were used to detect the amounts of G and D cells, expression of gastrin and somatostatin in gastric mucosa. RESULTS： Compared with the spleen-stomach weakness syndrome group, spleen-stomach dampness-heat syndrome group showed significant difference in amounts of G and D cells, G/D, expression of gastrin and somatostatin in gastric mucosa （130.54 ± 35.62 vs 111.13 ± 23.79, 54.98 ± 19.63 vs 67.01 ± 21.56, 2.74 ± 1.36 vs 1.87 ± 1.36, 34.72 ± 17.24 vs 27.72 ± 14.23, 13.90 ± 7.22 vs 19.23 ± 7.96, P 〈 0.05 or 0.01）. CONCLUSION： Elevated G cell level leads to raised gastrin expression, decreased D cell level leads to lower somatostatin expression, which may be pathological basis for spleen-stomach dampness-heat syndrome. Elevated D cell level leads to lower somatostatin expression, decreased G cell level leads to lower gastrin expression, which may be the pathological basis for spleenstomach weakness syndrome.