肠易激综合征合并焦虑抑郁患者胃肠激素表达特征分析

Characteristics of expression of gastrointestinal hormone in patients with irritable bowel syndrome accompanied with anxiety and depression

目的分析肠易激综合征合并焦虑抑郁患者胃肠激素表达特征,探讨患者焦虑抑郁和激素分泌水平之间的关系。方法选取2012年1月至2014年12月我院收治的肠易激综合征患者150例作为研究对象,依据患者是否发生焦虑抑郁分为焦虑抑郁组(59例)和非焦虑抑郁组(91例)。检测比较两组患者的胆囊收缩素、胃动素、生长抑素、血管活性肠肽和降钙素基因相关肽表达水平以及两组患者不同时段的结肠动力指数。结果焦虑抑郁组患者生长抑素(SS)和血管活性肠肽(VIP)表达水平显著高于非焦虑抑郁组患者(P<0.05);胃动素(MTL)和胆囊收缩素(CCK)表达水平显著低于非焦虑抑郁组患者(P<0.01);两组患者降钙素基因相关肽(CGRP)表达水平比较差异无统计学意义(P>0.05)。焦虑抑郁组患者空腹状态下乙状结肠动力指数高于非焦虑抑郁组(P<0.01)、餐后0.5 h和1 h乙状结肠动力指数低于非焦虑抑郁组,差异均有统计学意义(P<0.01或0.05)。结论肠易激综合征合并焦虑抑郁患者胆囊收缩素、胃动素、生长抑素、血管活性肠肽水平异常会影响患者的胃结肠反射功能;肠易激综合征患者的焦虑抑郁和激素分泌水平之间可能存在内在联系,有待进一步深入研究。

Objective To analyze the characteristics of gastrointestinal hormones in patients with irritable bowel syndrome aecompanied with anxiety and depression, and investigate the correlation between gastrointestinal hormones and anxiety depression. Methods A total of 150 patients with irritable bowel syndrome in our hospital from January 2012 to December 2014 were selected and divided into the anxiety depression group （59cases） and non-anxiety depression group （91cases） according to accompanied with anxiety and depression or not, The expression of cholecystokinin, motilin, somatostatin, vasoactive intestinal peptide and calcitonin peptide gene related peptide, and colonic motility index in different periods were compared between two groups. Results The expression of somatostatin （SS） , vasoactive intestinal peptide level（VIP） in anxiety depression group were significantly higher than those in the non-anxiety depression group （P 〈0.05）, and the expression of cholecystokinin （CCK） , motilin （MTL） in anxiety depression group were significantly lower than those of non- anxiety depression group （ P 〈 0. 01 ） ; that was no significant difference of the expression of ealeitonin gene related peptide was found between the two groups （ P 〉 0. 05 ）. The dynamic index of fasting state in anxiety depression group was significantly higher than that of non-anxiety depression group, but dynamic index of 0. 5h and 1 h after meal in anxiety depression group were significantly lower than those of the non-anxiety depression group （P 〈 0. 01 or P 〈 0.05 ）. Conclusions The abnormal of cholecystokinin, motilin, somatostatin, vasoactive intestinal peptide can affect the gastrocolic reflex in patients with irritable howe1 syndrome accompanied with anxiety and depression; there may be some intrinsic links between gastrointestinal hormones and anxiety depression,which needs further research.