5-羟色胺转运体表达与肠易激综合征躯体及心理症状的相关性

Correlation between the expression of serotonin transporter and somatic and psychological symptoms of irritable bowel syndrome

目的研究5-羟色胺转运体（SERT）mRNA及蛋白表达水平与肠易激综合征（IBS）患者躯体和心理症状的相关性。方法选取消化科门诊IBS患者254例为病例组，健康体检者及志愿者120名为对照组。采用实时定量PCR检测SERTmRNA，Western印迹分析检测SERT的蛋白表达量，应用精神心理症状自评量表（SCL-90）评测研究对象，探讨SERT蛋白表达与心理症状之间的相关性。结果便秘型肠易激综合征（C—IBS）95例，腹泻型肠易激综合征（D-IBS）116例，交替型肠易激综合征（A—IBS）43例。C—IBS组SERTmRNA及蛋白表达（0．58±0．24；0．99±0．51）显著高于A—IBS组（0．37±0．22；0．67±0．34）、D-IIBS组（0．41±0．26；0．71±0．41）和对照组（0．42±0．29；0．78±0．47）（均数差异=0．21、0．17、0．16，均P〈0．01；均数差异=0．31、0．27、0．21，均P〈0．05），AIBS组与D-IBS组间比较差异无统计学意义（P〉0．05）。SERT蛋白表达量与躯体化症状（r＝-0．67，P〈O．01）、抑郁因子（r＝-0．81，P〈0．01）、焦虑因子（r＝-0．72，P〈0．01）和敌对因子呈负相关（r＝-0．66，P〈0．01），与人际关系敏感、强迫症状、恐惧、偏执和精神病因子均不存在相关性（P〉0．05）。结论结肠黏膜SERTmRNA及蛋白的水平与IBS患者的躯体及心理症状相关，患者SERTmRNA及蛋白表达越多越容易出现便秘症状，而SERT蛋白含量越少越容易出现躯体化、焦虑、抑郁和敌对的情绪表现。

Objective To explore the correlation of the expression of serotonin transporter （SERT） at mRNA and protein level with psychological and somatic symptoms of irritable bowel syndrome （IBS）. Methods A total of 254 out-patients of the Department of Gastroenterology were selected as case group, and 120 healthy persons and volunteers were set as control group. The expression of SERT at mRNA level was tested by real-time polymerase chain reaction （PCR） and the expression of SERT at protein level was detected with Western blotting. The study objects were evaluated by psychological and somatic symptom self-rating scale （SLC-90） and the correlation between the expression of SERT at protein level and psychological symptoms was explored. Results There were constipation irritable bowel syndrome （C-IBS）, diarrhea irritable bowel syndrome （D-IBS） and alternating diarrhea and constipation irritable bowel syndrome （A-IBS）. The expressions of SERT at mRNA and protein level in C-IBS （0.58 ± 0. 24;0. 99±0. 51） were significantly higher than those in A-IBS group （0.37±0.22;0.67±0.34）, D-IBS group （0.41±0.26;0.71±0.41） and control group（0.42±0.29 ;0. 78±0.47） （P〈0.05）, there was no significant difference between A-IBS and D-IBS （P 〉 0. 05）. There was negative correlation between SERT expression at protein level and psychological symptoms （r=-0. 67, P〈0.01）, depression factor （r= -0.81, P〈0.01）, anxiety factor （r=-0.72, P〈0.01） and hostility factor （r=-0.66, P〈0.01）. There was no correlation between SERT expression and interpersonal sensitivity, obsessive-compulsive symptoms, terror, paranoia and psychological factors （P〈0.05）. Conclusions The expressions of SERT at mRNA and protein level in colonic mucosa may affect psychological and somatic symptoms of IBS patients. The higher SERT expressions at mRNA and protein level, constipation may be more susceptible. However the lower SERT expression at protein level, more emotional performance of somatization, anxiety, depression and hostility may be shown.