IBS患者血浆5-HT的变化及其与伴发焦虑、抑郁状态的相关性研究

Correlation Study of Plasma 5-HT of IBS Patients and the Status of Anxiety and Depression Associated

【目的】探讨不同亚型肠易激综合征（IBs）患者血浆5-羟色胺（5-HT）其代谢产物5-羟基吲哚乙酸（5-HIAA）水平变化及其与伴发焦虑和（或）抑郁状态的相关性。【方法】选取2014年4月至2015年4月中南大学湘雅二医院消化内科确诊的便秘型IBs（IBSC）及腹泻型IBS（IBS-D）患者为观察组，同期抽取结肠单发息肉摘除术后至少1年，同期经结肠镜复查正常者为对照组。应用汉密尔顿焦虑量表及抑郁量表对研究对象进行精神心理评估，并抽取外周血检测其血浆5-HT及其5-HIAA的浓度。比较IB孓C组、IB孓D组及对照组血浆5-HT及5-HIAA浓度的变化，并比较1t38伴发焦虑、抑郁状态血浆5-HT及5-HIAA浓度变化。【结果IIBS-C、IB孓D和对照组伴发焦虑状态百分比分别为14．3％、61．1％、9．5％，伴发抑郁状态的分别为42．9％、22．2％、9．5％；IBS组伴发焦虑、抑郁状态的比例高于对照组，其中IBS-C伴发抑郁状态的比例高于对照组，IBS-D伴发焦虑状态比例高于对照组（P〈0．05）。IBSC组、IBSD组血浆5-HT水平显著高于对照组（均P〈0．05），三组血浆5-HIAA的浓度无统计学差异。IBS伴发抑郁状态者血浆5-HT浓度高于无伴发者（P〈0．05）；IBS伴发焦虑状态者血浆5-HT浓度与未伴发者无统计学差异（P〉0．05）。【结论】IBS患者伴发焦虑状态、抑郁状态的比例高于正常者；IBS患者血浆5-HT浓度高于正常者，且伴发抑郁状态者升高更为明显。

[Objects] To explore 5-hydroxytryptamine （5-HT） and its metabolite 5- hydroxyindoleacetic acid （5-HIAA） of patients with different subtypes of irritable bowel syndrome （IBS） and the possible relation- ship with anxiety and depression. [Methods] Patients diagnosed as constipation type IBS （IBS-C） and diarrhea type IBS （IBS-D） in the Department of Internal Medicine, Xiangya No. 2 Hospital, Central South University from April 2014 to April 2015 were selected as the observation group, and those who underwent removal of single colon polyps at least one year ago and showed Normal through colonoscopy examination were selected as the control group. The Hamilton anxiety scale and depression scale were used to evaluate the mental and psy- chological evaluation of the study subjects, and peripheral blood was taken to detect the concentration of plas- ma 5-HT and 5-HIAA. The changes of plasma 5-HT and 5-HIAA concentrations in IBS-C group, IBS-D group and the control group were compared, and the changes of plasma 5-HT and 5-HIAA concentrations in IBS pa- tients with anxiety and depression were analyzed.[Results] The percentages of associated anxiety of IBS-C, IBS-D and the control group were 14.3%, 61.1%, 9.5%, and depression associated with were 42.9%,22.2%, 9.5 % respectively; The proportion of associated anxiety and depression in the IBS group was higher than that in the control group, the proportion of IBS-C with depression was higher than that in control group, and the proportion of IBS-D with associated anxiety was higher than that in the control group （ P 〈0.05）. The plasma 5-HT levels in IBS-C group and IBS-D group were significantly higher than those in the control group （ P〈 0.05）. There was no significant difference in plasma 5-HIAA concentration between the three groups. Plasma concentrations of 5-HT in IBS patients associated with depression were higher than those without it （ P〈0.05）. There was no significant difference in plasma 5-HT concentration between IBS patients associated with or without anxiety （ P 〉0.05） .[Conclusions]The proportion of IBS patients with anxiety and depression is higher than that in normal subjects. The plasma 5-HT concentration in IBS patients is higher than that in the normal subjects, and their the state of 5-HT increased obviously.