肠易激综合征患者肠黏膜肥大细胞的变化

Alterations of enteric mucosal mast cells in patients with irritable bowel syndrome

目的:探讨肠易激综合征(irritablebowelsyndrome,IBS)与肠黏膜肥大细胞(mastcell,MC)及脱颗粒之间的关系方法:正常人10例和IBS患者20例(腹泻11例,便秘9例).每例于结肠镜下取盲肠、横结肠和直肠各2块,用免疫组化方法行MC染色,计算每高倍视野下MC的数量及脱颗粒MC所占MC总数的比例.结果:腹泻组IBS患者盲肠、横结肠黏膜MC数量显著高于正常对照组(P<0.01及P<0.05);直肠黏膜MC数量与正常对照组无显著差异(P>0.05).便秘组IBS患者在盲肠黏膜MC数量显著高于正常对照组(P<0.05),而横结肠、直肠黏膜MC数量与正常对照组无显著差异(P>0.05).盲肠腹泻组IBS患者盲肠MC数量显著高于便秘组(P<0.05),而在横结肠及直肠两组之间无显著差异.腹泻型IBS患者盲肠、横结肠、直肠黏膜脱颗粒MC比率显著高于正常对照组(P<0.05或P<0.01);便秘组IBS患者盲肠、直肠黏膜脱颗粒MC比率亦高于正常对照组(P<0.05),而在横结肠与正常对照组无显著差异(P>0.05);各部位肠黏膜腹泻组型IBS患者脱颗粒MC比率显著高于便秘组.

AIM: To study alterations of mast cells in colon mucosa of patients with irritable bowel syndrome. METHODS: Ten healthy volunteers and 20 patients with irritable bowel syndrome entered in this study. By colonoscopy biopsies, the mast cells (MC) in mucosa of cecal colon, transverse colon and rectum were stained by immunohistochemistry and the number of mast cells and percentage of degranulated mast cells were counted. RESULTS: MC number increased significantly in the cecum and transverse colon of diarrhea IBS patients, compared with controls (P <0.01 or P<0.05). MC number increased significantly in the cecum of constipation IBS patients compared with controls (P<0.05). MC number was significantly increased in the caecum of diarrhea IBS patients than constipation IBS patients (P <0.05). The percentages of degranulated mast cells in cecal colon, transverse colon and rectum mucosa of diarrhea IBS patients were significantly higher than those in constipation IBS patients and controls (P<0.01or P<0.05). CONCLUSION: The mast cells play an important role in the pathogenesis of irritable bowel syndrome.