肠易激综合征患者肠黏膜CGRP、SP水平的变化与临床症状的关系

Relationship between expression of CGRP/SP and clinical symptoms in irritable bowel syndrome

[目的]探讨肠易激综合征(IBS)患者结肠黏膜降钙素基因相肽(CGRP)和P物质(SP)表达水平及与IBS临床症状的相关性。[方法]对腹泻型IBS(IBS-D组)20例、便秘型IBS(IBS-C组)8例和正常对照组5例各取乙状结肠黏膜标本,应用免疫组织化学染色法分别检测CGRP和SP;同时以评分法评价消化道症状;分析各组CGRP、SP表达水平与消化道症状的相关性。[结果]IBS-D组CGRP表达水平显著高于IBS-C组、正常对照组(0.27±0.08∶0.21±0.06、0.19±0.04,P<0.05),IBS-C组与正常对照组比较差异无统计学意义。IBS-D组SP表达水平显著高于IBS-C组、正常对照组(0.27±0.11∶0.19±0.04、0.17±0.04,P<0.05),IBS-C组与正常对照组比较差异无统计学意义。肠黏膜SP表达水平与IBS患者腹痛(r=0.495,P=0.007)、排便变稀(r=0.382,P=0.045)呈正相关,与排便困难(r=-0.485,P=0.009)、排便干结(r=-0.382,P=0.045)负相关;CGRP与排便变稀(r=0.401,P=0.034)正相关,与排便干结(r=-0.401,P=0.034)负相关。[结论]CGRP、SP可能参与IBS的病理生理过程并与临床症状密切相关。

[Objective]To investigate the expression levels of substance P（SP）and calcitonin gene-related peptide（CGRP）in colon mucosa of patients with irritable bowel syndrome（IBS）. Furtherly, to explore the relationship between the levels of SP/CGRP and clinical symptoms in IBS patients. [Methods]Endoscopic biopsy from sigmoid colon were collected from 20 patients with diarrhea-predominant IBS（IBS-D）, 8 with constipation-predominant IBS（IBS-C）and 5 healthy volunteers. The immunohistochemical method was con- ducted to detect the expression of SP and CGRP The data were analyzed by Image Pro plus. Gastrointesti- nal symptoms were evaluated with method of point rating. The correlation analysis between CGRP/SP and gastrointestinal symptoms in IBS patients was evaluated by SPSS 17.0. [Results]Comparing with the IBS-C and healthy controls,significant up-regulation of SP and CGRP were found in IBS-D（CGRP.0. 27±0. 08 vs 0. 21±0. 06,0.19±0. 04,P〈0. 05;SP：0. 27±0.11 vs 0.19±0. 04,0.17±0. 04,P〈0. 05）. No significant difference was observed between IBS-C and controls. The expression of SP in the colonic mucosa was posi- tively correlated with abdominal pain （ r = 0. 495, P = 0. 007）, loose stool （r = 0. 382, P = 0. 045 ）, and wasnegative correlated with difficult defecation（r=-0. 485, P=0. 009）, dry stool（r=-0. 382, P= 0. 045）in patients with IBS. CGRP was positively correlated with loose stool（r=0. 401 ,P=0. 034） ,and was negative correlated with dry stool（r=-0. 401, P=0. 034）in patients with IBS. [Conelusion]CGRP and SP are in- volved in the development of IBS.