胃黏膜肥大细胞与功能性消化不良患者症状的关系研究

Research on the correlation between gastric mucosal mast cells and functional dyspeptic symptoms

目的探讨功能性消化不良(FD)患者胃黏膜肥大细胞(MC)的改变与消化不良症状的关系。方法选择2013年11月至2014年11月该院32例FD患者,按症状不同分为早饱组、餐后上腹胀组、上腹胀组、上腹痛组及上腹烧灼感组,另选14例无症状者作为对照组。均在胃镜检查时行胃窦、胃体黏膜活检并行免疫组织化学染色MC,计数MC数目并观察脱颗粒情况。结果胃体黏膜脱颗粒MC比例、MC脱颗粒程度餐后上腹胀组[(67.11±14.41)%、(30.63±9.63)%]较对照组[(50.98±10.02)%、(21.34±6.32)%]增加(P<0.05)。胃体黏膜MC密度、脱颗粒MC比例、MC脱颗粒程度上腹痛组[(132.00±57.00)个/mm2、(71.31±13.13)%、(32.96±9.44)%]较对照组[(84.00±33.00)个/mm2、(50.98±10.02)%、(21.34±6.32)%]增加(P<0.05)。胃窦黏膜MC密度餐后上腹胀组[(102.00±51.00)个/mm2]、上腹胀组[(111.00±62.00)个/mm2]、上腹痛组[(93.00±40.00)个/mm2]较对照组[(67.00±20.00)个/mm2]增加(P<0.05)。结论胃体、胃窦黏膜MC数目的变化及活化可能导致FD患者上腹痛、餐后腹胀等消化不良症状。

Objective To investigate the correlation between dyspeptic symptoms and the changes of gastric mucosal mast cells(MC)of the patients with functional dyspepsia(FD).Methods A total of 32 patients with FD and 14 asymptomatic controls were enrolled in this research,after mucosa biopsy at gastric antrum and gastric body while endoscopy,immunohistochemical stain was used to analyze the quantity and degranulation of MCs.Results The ratio and degree of degranulated MCs in gastric body mucosa of FD patients with postprandial upper abdominal distress were(67.11±14.41)%,(30.63±9.63)%,which increased more than the control group[(50.98±10.02)%,(21.34±6.32)%],there was statistically significant difference(P<0.05).The quantity of MCs,the ratio and degree of degranulated MCs in gastric body mucosa of FD patients with upper abdominal pain were(132.00±57.00)/mm 2,(71.31±13.13)%,(32.96±9.44)%,which increased more than the control group[(84.00±33.00)/mm 2,(50.98±10.02)%,(21.34±6.32)%)],there was statistically significant difference(P<0.05).The quantity of MCs in gastric antrum of FD patients with postprandial upper abdominal distress[(102.00±51.00)/mm 2],abdominal bloating[(111.00±62.00)/mm 2]and upper abdominal pain[(93.00±40.00)/mm 2]increased more than the control group[(67.00±20.00)/mm 2)],there was statistically significant difference(P<0.05).Conclusion Changes in the number of MCs and its activation in both gastric body and antrum mucosa may lead to upper abdominal pain and postprandial abdominal bloating.