中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
6期
368-371
,共4页
于岩波%左秀丽%陈飞雪%董艳艳%李延青
于巖波%左秀麗%陳飛雪%董豔豔%李延青
우암파%좌수려%진비설%동염염%리연청
脑源性神经营养因子%肠易激综合征%腹痛%显微镜检查,电子%神经纤维%肠黏膜
腦源性神經營養因子%腸易激綜閤徵%腹痛%顯微鏡檢查,電子%神經纖維%腸黏膜
뇌원성신경영양인자%장역격종합정%복통%현미경검사,전자%신경섬유%장점막
Brain-derived neurotrophic factor%Irritable bowel syndrome%Abdominal pain%Microscopy,electron%Nerve fibers%Intestinal mucosa
目的 探讨肠易激综合征(IBS)患者肠黏膜脑源性神经营养因子(BDNF)的表达水平改变及其与腹痛症状的相关性.观察IBS患者肠黏膜神经纤维密度和神经纤维超微结构的异常.方法 实验组选取2008年9月至2010年1月来本院消化科就诊且符合罗马Ⅲ诊断标准的IBS患者,根据其临床特点分为腹泻型IBS(D-IBS)和便秘型IBS(C-IBS)两个亚型.对照组选择来我院行结肠镜检查发现有结肠息肉者.所有受试者根据就诊前两周的腹部症状填写腹痛和(或)腹部不适自评量表,并行结肠镜检查,在直肠乙状结肠交界处取肠黏膜活检标本4块,2块用于蛋白质提取并检测BDNF的表达水平;1块用于石蜡切片的PGP 9.5免疫组织化学染色;1块用于透射电镜观察肠黏膜神经纤维超微结构改变.结果 本研究共入选IBS患者40例,其中D-IBS患者2l例,C-IBS 患者19例;对照组21例.IBS患者的腹痛程度评分和频率评分为(2.3±0.8)分和(2.1±0.7)分,均显著高于对照组[(0.4±0.7)分和(0.3±0.5)分,P值均＜0.01].与对照组相比,IBS患者肠黏膜BDNF蛋白表达水平明显升高(P=0.003),且肠黏膜BDNF含量与患者腹痛和(或)腹部不适程度评分和频率评分均有良好的相关性(r值分别＝0.57和0.46,P值均＜0.01).免疫组织化学染色显示,IBS患者肠黏膜神经纤维分布密度明显高于对照组(P＜0.01),且IBS患者肠黏膜神经纤维存在超微结构的改变.结论 IBS患者腹痛症状的发生可能与肠黏膜BDNF表达增加有关.同时IBS 患者肠黏膜神经纤维存在超微结构破坏,可引起肠黏膜BDNF含量升高,并导致IBS患者肠黏膜神经纤维密度增加.
目的 探討腸易激綜閤徵(IBS)患者腸黏膜腦源性神經營養因子(BDNF)的錶達水平改變及其與腹痛癥狀的相關性.觀察IBS患者腸黏膜神經纖維密度和神經纖維超微結構的異常.方法 實驗組選取2008年9月至2010年1月來本院消化科就診且符閤囉馬Ⅲ診斷標準的IBS患者,根據其臨床特點分為腹瀉型IBS(D-IBS)和便祕型IBS(C-IBS)兩箇亞型.對照組選擇來我院行結腸鏡檢查髮現有結腸息肉者.所有受試者根據就診前兩週的腹部癥狀填寫腹痛和(或)腹部不適自評量錶,併行結腸鏡檢查,在直腸乙狀結腸交界處取腸黏膜活檢標本4塊,2塊用于蛋白質提取併檢測BDNF的錶達水平;1塊用于石蠟切片的PGP 9.5免疫組織化學染色;1塊用于透射電鏡觀察腸黏膜神經纖維超微結構改變.結果 本研究共入選IBS患者40例,其中D-IBS患者2l例,C-IBS 患者19例;對照組21例.IBS患者的腹痛程度評分和頻率評分為(2.3±0.8)分和(2.1±0.7)分,均顯著高于對照組[(0.4±0.7)分和(0.3±0.5)分,P值均＜0.01].與對照組相比,IBS患者腸黏膜BDNF蛋白錶達水平明顯升高(P=0.003),且腸黏膜BDNF含量與患者腹痛和(或)腹部不適程度評分和頻率評分均有良好的相關性(r值分彆＝0.57和0.46,P值均＜0.01).免疫組織化學染色顯示,IBS患者腸黏膜神經纖維分佈密度明顯高于對照組(P＜0.01),且IBS患者腸黏膜神經纖維存在超微結構的改變.結論 IBS患者腹痛癥狀的髮生可能與腸黏膜BDNF錶達增加有關.同時IBS 患者腸黏膜神經纖維存在超微結構破壞,可引起腸黏膜BDNF含量升高,併導緻IBS患者腸黏膜神經纖維密度增加.
목적 탐토장역격종합정(IBS)환자장점막뇌원성신경영양인자(BDNF)적표체수평개변급기여복통증상적상관성.관찰IBS환자장점막신경섬유밀도화신경섬유초미결구적이상.방법 실험조선취2008년9월지2010년1월래본원소화과취진차부합라마Ⅲ진단표준적IBS환자,근거기림상특점분위복사형IBS(D-IBS)화편비형IBS(C-IBS)량개아형.대조조선택래아원행결장경검사발현유결장식육자.소유수시자근거취진전량주적복부증상전사복통화(혹)복부불괄자평량표,병행결장경검사,재직장을상결장교계처취장점막활검표본4괴,2괴용우단백질제취병검측BDNF적표체수평;1괴용우석사절편적PGP 9.5면역조직화학염색;1괴용우투사전경관찰장점막신경섬유초미결구개변.결과 본연구공입선IBS환자40례,기중D-IBS환자2l례,C-IBS 환자19례;대조조21례.IBS환자적복통정도평분화빈솔평분위(2.3±0.8)분화(2.1±0.7)분,균현저고우대조조[(0.4±0.7)분화(0.3±0.5)분,P치균＜0.01].여대조조상비,IBS환자장점막BDNF단백표체수평명현승고(P=0.003),차장점막BDNF함량여환자복통화(혹)복부불괄정도평분화빈솔평분균유량호적상관성(r치분별＝0.57화0.46,P치균＜0.01).면역조직화학염색현시,IBS환자장점막신경섬유분포밀도명현고우대조조(P＜0.01),차IBS환자장점막신경섬유존재초미결구적개변.결론 IBS환자복통증상적발생가능여장점막BDNF표체증가유관.동시IBS 환자장점막신경섬유존재초미결구파배,가인기장점막BDNF함량승고,병도치IBS환자장점막신경섬유밀도증가.
Objective To investigate the correlation between the expression changes of brain-derived neurotrophic factor (BDNF) in colon mucosa and abdominal pain in irritable bowel syndrome (IBS). The density of nerve fiber in colon mucosa and ultrastructural alterations of nerve fiber in IBS were also observed. Methods From September 2008 to January 2010,the IBS patients who visited the department of gastroenterology of our hospital and met the Rome Ⅲ diagnosis criteria were selected and divided into IBS with diarrhea (D-IBS) and IBS with constipation (C-IBS) according to their clinical features. The patients with colon polyps detected by colonoscopy in our hospital were selected as control group. All subjects were asked to fill in Self-Rating abdominal pain or abdominal uncomfortable Scale according to abdominal symptom in the last 2 weeks before visit and underwent colonoscopy. Four biopsy specimens were taken from the colon mucosa of rectosigmoid junction. Ofwhich,two specimens were for protein isolation and detection of BDNF expression level,one specimen was used for PGP 9. 5 immunohistochemistry staining in paraffin slices. Another specimen was used to observe the ultrastructure changes of nerve fiber in colon mucosa under transmission electron microscopy. Results Total 40 IBS patients were enrolled in this study,of those 21 were D-IBS patients,19 were C-IBS patients,and 21 were controls. The abdominal pain severity score and frequency score of IBS patients were (2. 3±0. 8) and (2. 1±0. 7),which were significantly higher than those of control group (0. 4±0. 7 and 0. 3±0. 5,P＜0. 001). Compared with the control group,the BDNF expression in colon mucosa was significantly elevated in IBS patients (P= 0. 003 ),and which correlated with the severity and frequency of abdominal pain/discomfort (r=0. 57,P＜0. 001and r=0. 46,P= 0. 003,respectively). The immunohistochemistry result indicated that the nerve fiber density in colon mucosa of IBS patients was significantly higher than that of controls,and there were ultrastructural changes of colon mucosal nerve fibers in IBS patients. Conclusion Increased colon mucosal BDNF expression may be associated with abdominal pain symptom in IBS patients. The impaired ultrastructural of mucosal nerve fibers may cause the increased BDNF expression in colon mucosa,and result in the increased mucosal nerve fiber density in IBS patients.
