CAJ | 학술논문

目的观察非糜烂性反流病(NERD)和反流性食管炎(RE)患者食管黏膜内P物质(SP)和降钙素基因相关肽(CGRP)免疫反应阳性产物的表达,探讨其在NERD发病中的作用.方法选择有典型胃食管反流症状并经反流性疾病诊断问卷(RDQ)调查、PPI试验、胃镜检查及食管24h pH检测诊断为GERD患者51例,其中RE组21例,NERD酸反流阳性组(NERD+组)12例,NERD酸反流阴性组(NERD-组)18例,采用免疫组化方法在显微镜下观察NERD、RE患者食管黏膜内SP、CGRP的表达,应用彩色病理图像分析软件,分析计算SP、CGRP免疫反应的阳性指数(PI),并与正常对照组10例比较.结果 NERD-组食管黏膜内SP、CGRP的Pl值为96.77±31.74和24.76±29.15,明显高于NERD+组(73.64±31.38、9.78±10.30)、RE组(67.56±34.62、9.61±6.20)及正常对照组(59.82±46.15、8.64±12.12)(P均<0.05).结论 SP、CGRP在NERD-的患者食管黏膜内有明显表达,可能在食管内脏感觉中发挥着重要的作用.
목적 관찰비미란성반류병(NERD)화반류성식관염(RE)환자식관점막내P물질(SP)화강개소기인상관태(CGRP)면역반응양성산물적표체,탐토기재NERD발병중적작용.방법 선택유전형위식관반류증상병경반류성질병진단문권(RDQ)조사、PPI시험、위경검사급식관24h pH검측진단위GERD환자51례,기중RE조21례,NERD산반류양성조(NERD+조)12례,NERD산반류음성조(NERD-조)18례,채용면역조화방법 재현미경하관찰NERD、RE환자식관점막내SP、CGRP적표체,응용채색병리도상분석연건,분석계산SP、CGRP면역반응적양성지수(PI),병여정상대조조10례비교.결과 NERD-조식관점막내SP、CGRP적Pl치위96.77±31.74화24.76±29.15,명현고우NERD+조(73.64±31.38、9.78±10.30)、RE조(67.56±34.62、9.61±6.20)급정상대조조(59.82±46.15、8.64±12.12)(P균<0.05).결론 SP、CGRP재NERD-적환자식관점막내유명현표체,가능재식관내장감각중발휘착중요적작용.
Objective To evaluate the expression of substance P (SP) and caltenin gene related peptide (CGRP) in esophagueal mucosa from patients with non-erosive gnstroesophageal reflux disease (NERD) and reflux esophagitis (RE) and to explore their role in the development of NERD. Methods Fif-ty-one patients with typical symptoms of gnstroesophageal reflux disease (GERD) were evaluated with reflux disease questionnaire (RDQ), PPI test, endoscopy and 24hr esophageal pH monitoring. The patients were then divided into RE group (n = 21), NERD group with acid refluux (NERD+, n = 12) and NERD group without acid reflux (NERD-, n = 18) according to the evaluation results. The expression of SP and CGRP in esophagus mucosa from these patients and 10 healthy control subjects were assayed by immunohistochemis-try, and the stain positive index (PI) was calculated by Color patho-image analysis software and compared. Results The PIs of SP and CGRP in NERD- group were 96.77±31.74 and 24.76±29.15, respectively, which were significantly higher than those of NERD+ group (73.64±31.38, 9.78±10.30, respectively, P < 0.05), RE group (67.56±34.62, 9.61±6.20, respectively, P < 0.05) and control group (59.82± 46.15, 8.64±12.12, respectively, P < 0.05). Conclusion Expressions of SP and CGRP in esophagus mucosa from NERD patients without detectable acid reflux are significantly increased, they may play an im-portant role in esophageal visceral sensitivity.