肠易激综合征患者肠黏膜肥大细胞在内脏高敏感机制中的可能作用和临床意义

Investigation on the action of mast cells for visceral hypersensitivity in patients with irritable bowel syndrome

目的:探讨肠易激综合征(IBS)患者肠黏膜肥大细胞(MC)对内脏敏感性改变的作用及其临床意义。方法:分别检测50例IBS患者和20例正常对照组患者的肛门直肠括约肌静息压、最大收缩压和括约肌松弛压,再分别取样各患者回肠末端、回盲部、升结肠和乙状结肠处的4块黏膜标本,采用甲苯胺蓝改良染色法进行MC染色并分析其密度。结果:IBS患者肛门直肠括约肌的静息压、最大收缩压和松弛压与正常对照组比较差异无统计学意义(P>0.05);感觉阈值、疼痛阈值和排便阈值均显著低于正常对照组(P<0.05);IBS组患者回肠末端、回盲部以及升结肠黏膜MC密度均显著高于正常对照组(P<0.05);腹泻型IBS组患者回肠末端、回盲部以及升结肠黏膜MC密度均显著高于便秘型IBS组(P<0.05)。结论:IBS患者肠黏膜MC存在显著异常,可能对IBS内脏高敏感性的形成具有重要作用。

AIM： To investigate the action of Mast cells for visceral hypersensitivity in patients with irritable bowel syndrome.METHODS： The anorectal resting pressure,squeeze pressure and relaxation pressure of 50 patients with IBS and 20 healthy volunteers were detected,4 pieces of mucous membrane specimen were sampled from terminal ileum,ileocecal junction,ascending colon and sigmoid colon in all patients and then used toluidin blue dyeing to stain the MC and analysed the density.RESULTS： The anorectal resting pressure,squeeze pressure and relaxation pressure of patients with IBS had no significantly difference compared with control group（P0.05）,while the sensation thresholds,discomfort thresholds and defecation thresholds were much lower than those in control group（P0.05）;the density of MC in terminal ileum,ileocecal junction and ascending colon of patients with IBS were significantly higher than control group,the difference was statistically significant（P0.05）;while the density of MC in terminal ileum,ileocecal junction and ascending colon of patients with diarrhea IBS were significantly higher than those of constipation IBS,the difference was statistically significant（P0.05）.CONCLUSION： There exists a significant abnormality of MC in patients with IBS and it possibly play an important role in the formation of visceral hypersensitivity.