肠易激综合征患者内皮素和一氧化氮含量变化的意义

Role of Endothelin and Nitric Oxide in the Pathogenesis of Irritable Bowel Syndrome

背景:肠易激综合征(IBS)是以肠平滑肌功能紊乱为主要表现的多因素疾病,目前神经和胃肠激素在其发病机制中的作用甚受关注。目的:探讨内皮素(ET)和一氧化氮(NO)在IBS等疾病腹泻患者中的变化规律及其与病程的关系。方法:选取IBS腹泻型患者21例,糖尿病腹泻患者17例,甲状腺功能亢进腹泻患者15例,溃疡性结肠炎(UC)患者15例,同时设立正常对照组16名。分别采用放射免疫法和比色法测定患者发作期和缓解期血浆ET和NO代谢产物NO2-/NO3-的含量变化。结果:IBS和糖尿病患者的发作期血浆ET含量均较正常对照组显著增高(P<0.05)。IBS患者的发作期血浆NO含量显著高于正常对照组(P<0.05),糖尿病患者则低于正常对照组(P<O.05)。IBS患者的缓解期ET、NO含量较发作期显著降低(P<0.05),其他腹泻患者则无此改变。结论:ET可诱发IBS患者肠道高反应性,ET/NO平衡失调可能是诱发和加重IBS的原因之一。

Background: Irritable bowel syndrome (IBS) is a multifactorial disease which is characterized by the dysfunction of intestinal smooth muscle. Now the roles of neural hormone and gastrointestinal hormone played in the pathogenesis of IBS are noticed. Aims: To investigate the role of endothelin (ET) and nitric oxide (NO) in the pathogenesis of IBS and diarrhea in other diseases, as well as the correlation between the ET/NO and the duration of the diseases. Methods: Among the 68 patients with diarrhea, 21 IBS, 17 diabetes mellitus, 15 hyperthyroidism and 15 ulcerative colitis (UC) were available for evaluation of ET and NO, while 16 healthy subjects were served as normal controls. ET was detected by radioimmunoassay and NO by chromatometry. Results: The concentration of plasma ET was higher in both IBS and diabetes mellitus during episodic attack (P<0.05), and the concentration of plasma NO was markedly elevated in IBS and reduced in diabetes mellitus as compared with that in the control group (P<0.05). During the remission period, the concentration of ET and NO in IBS were markedly reduced (P<0.05), whereas there were no significant changes in other diarrhea patients. Conclusions: ET can induce hyper-responsiveness of bowel in IBS, the imbalance between ET and NO may induce and enhance the features of IBS.