功能性消化不良患者外周血胃动素、神经肽Y和瘦素水平研究

Peripheral Blood Motilin,Neuropeptide Y and Leptin Levels in Patients with Functional Dyspepsia

背景:功能性消化不良(FD)病理生理机制复杂,迄今尚未完全明确,胃肠激素分泌紊乱可能与其发病有关。目的:探讨FD不同亚型与胃肠激素胃动素(MTL)、神经肽Y(NPY)和瘦素(LEP)的关系。方法:57例诊断符合罗马Ⅲ标准的FD患者纳入研究,其中上腹痛综合征(EPS)24例,餐后不适综合征(PDS)33例,10名健康志愿者作为对照组。采用放射免疫法测定空腹和餐后外周血MTL、NPY、LEP水平。结果:EPS组、PDS组外周血空腹MTL水平[(182.90±108.57)pg/mL、(145.21±67.18)pg/mL对(224.47±64.55)pg/mL,P<0.05]、EPS组空腹NPY水平[(57.40±28.75)pg/mL对(90.75±49.57)pg/mL,P<0.01]、PDS组空腹和餐后NPY水平[空腹:(38.25±20.66)pg/mL对(90.75±49.57)pg/mL,P<0.01;餐后:(30.26±15.12)pg/mL对(65.23±54.42)pg/mL,P<0.01]均显著低于同时点对照组,以PDS组为著;PDS组空腹、餐后NPY水平均显著低于同时点EPS组(P<0.05)。三组间外周血空腹、餐后LEP水平均无明显差异(P>0.05)。结论:FD不同亚型的发病机制存在差异并与胃肠激素水平有关,其中PDS亚型与MTL、NPY水平降低密切相关。

Background ： The pathophysiology of functional dyspepsia （FD） is complicated and unclarified yet. Gastrointestinal hormone dysfunction may contribute to the development of FD. Aims ： To investigate the correlation of different subtypes of FD with gastrointestinal hormone motilin （MTL）, neuropeptide Y （NPY） and leptin （LEP）. Methods： A total of 57 FD patients fulfilling Rome m criteria were recruited and divided into epigastrie pain syndrome （EPS） group （ n = 24 ） and postprandial distress syndrome （ PDS ） group （ n = 33 ）. Ten healthy volunteers were served as controls. Fast and postprandial levels of MTL, NPY and LEP in peripheral blood were detected by radioimmunoassay. Results： Peripheral levels of fast MTL in EPS and PDS groups [ （182.90 ± 108.57 ） pg/mL and （145.21 ± 67.18 ） pg/mL vs. （224.47 ± 64.55） pg/mL, P〈0.05], fast NPY in EPS group [（57.40±28.75） pg/mLvs. （90.75 ±49.57） pg/mL, P〈0.01], and fast and postprandial NPY in PDS group [ fast level ： （ 38.25 ± 20.66 ） pg/mL vs. （ 90.75 ± 49.57 ） pg/mL, P 〈 0.01 ; postprandial level： （30.26 ± 15.12） pg/mL vs. （65.23 ±54.42） pg/mL, P 〈0.01 ] were significantly lower than those in control group at same time points, especially the PDS group. Fast and postprandial levels of NPY were significantly lower in PDS group than in EPS group at same time points （ P 〈 0.05 ）. No significant differences were observed in peripheral LEP levels among the three groups at any time points （ P 〉 0.05 ）. Conclusions ： The pathogenic mechanism of FD is related to the level of gastrointestinal hormones, and is different in EPS and PDS subtypes. Reduced MTL and NPY levels might be involved in the pathogenesis of PDS.