肠易激综合征患者5-羟色胺及5-羟色胺2B受体变化的研究

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摘要目的观察肠易激综合征（IBS）患者血浆和结肠黏膜5-羟色胺（5-HT）及5-HT2B受体的表达情况，并探讨5-HT 及5-HT2B受体在IBS 发病机制中的作用。方法选取2016年1月～2017年5月于大连市友谊医院消化内科确诊的48例腹泻型IBS（IBS-D）及便秘型IBS（IBS-C）患者，其中IBS-D患者26例（IBS-D组），IBS-C患者22例（IBS-C 组）；另选取28例同期行结肠癌或结肠息肉筛查且结肠镜检查结果阴性者作为对照组。应用腹部症状评分量表对受试者进行评分，采用ELISA 法检测受试者的血浆5-HT 及5-HT2B受体浓度。结肠镜下获取升结肠处结肠黏膜标本，采用逆转录PCR 检测5-HT mRNA 及5-HT2B受体mRNA 的表达水平，并分析血浆5-HT 及5-HT2B受体水平与腹部症状评分的相关性。结果 IBS-D 及IBS-C 组患者的腹部症状评分高于对照组，差异有统计学意义（P＜0.05）；IBS-D 及IBS-C 组患者的血浆5-HT 及5-HT2B受体浓度高于对照组，差异有统计学意义（P＜0.05）；IBS-D 及IBS-C 组患者结肠黏膜组织5-HT 及5-HT2B受体mRNA表达量高于对照组，差异有统计学意义（P＜0.05）。Spearman 分析结果显示，IBS-D 和IBS-C 组患者血浆5-HT 的表达量与腹部症状评分成正相关（r=0.82、0.79，P＜0.05）；IBS-D 和IBS-C 组患者血浆5-HT2B受体的表达量与腹部症状评分成正相关（r=0.78、0.76，P＜0.05）；对照组血浆5-HT 及5-HT2B受体的表达量与腹部症状评分无相关性（P＞0.05）。结论 5-HT 及5-HT2B 在IBS 患者中显著升高，且血浆5-HT 及5-HT2B 与IBS 患者的腹部症状评分成正相关，提示5-HT 及5-HT2B受体可能参与了IBS 患者腹痛的发生。

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关键词 ：肠易激综合征, 5-羟色胺, 5-羟色胺2B受体, 结肠组织, 腹痛

Abstract：Objective To observe the changes of 5-hydroxytryptamine (5-HT) and 5-HT2B receptor in the patients with irritable bowel syndrome (IBS).And to explore the role of 5-HT and 5-HT2B receptor in the pathogenesis of IBS.Methods From January 2016 to may 2017, 48 patients with diarrhea type IBS (IBS-D) and constipation type IBS (IBSC) were selected from the Department of Gastroenterology, Dalian Friendship Hospital, including 26 cases of IBS-D patients (IBS-D group), 22 cases of IBS-C patients (IBS-C group).In addition, those undergoing colonoscopy for polyps or cancer surveillance with negative results were included in the control group (28 cases).The abdominal symptom scale was used to score the subjects, and the Plasma 5-HT and 5-HT2B receptor concentrations were detected by ELISA.Specimens were obtained from the ascending colon during the colonoscopy, and the expression level of 5-HT mRNA and 5-HT2B receptor mRNA in colonic mucosa were detected by reverse transcription PCR.The relationship between 5-HT and 5-HT2B receptor levels and abdominal symptoms were calculated.Results The scores of abdominal symptoms in IBS-D and IBS-C groups were higher than those in the control group, the differences were statistically significant (P＜0.05).The plasma concentrations of 5-HT and 5-HT2B receptor in IBS-D and IBS-C groups were higher than those in the control group, the differences were statistically significant (P＜0.05).The expression of 5-HT and 5-HT2B receptor mRNA in colonic mucosa of IBS-D and IBS-C group were higher than those of control group, the differences were statistically significant (P＜0.05).Spearman analysis showed that the expression of plasma 5-HT in IBS-D and IBS-C group were positively correlated with abdominal symptom score (r=0.82, 0.79；P＜0.05).The plasma 5-HT2B receptor expression in IBS-D and IBS-C groups were positively correlated with abdominal symptom scores (r=0.78, 0.76；P＜0.05).There was no correlation between the expression of 5-HT and 5-HT2B receptor and abdominal symptom score in the control group (P＞0.05).Conclusion T5-HT and 5-HT2B are significantly increased in IBS patients, and plasma 5-HT and 5-HT2B are positively correlated with the abdominal symptom score of IBS patients, suggesting that 5-HT and 5-HT2B receptors may be involved in the occurrence of abdominal pain in IBS patients.

Key words： Irritable bowel syndrome 5-hydroxytryptamine 5-hydroxytryptamine 2B receptor Colon tissues Abdominal pain

引用本文:

孙咏红; 张野; 王宇; 王福成; 李青; 孙秀丽; 张静. 肠易激综合征患者5-羟色胺及5-羟色胺2B受体变化的研究[J]. 中国当代医药, 2020, 27(11): 16-19.
SUN Yong-hong; ZHANG Ye; WANG Yu; WANG Fu-cheng; LI Qing; SUN Xiu-li; ZHANG Jing. Changes study of 5-hydroxytryptamine and 5-hydroxytryptamine 2B receptor in the patient with irritable bowel syndrome. 中国当代医药, 2020, 27(11): 16-19.

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