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感染后肠易激综合征与非感染后肠易激综合征的临床表型差异分析

Clinical Difference between Post Infectious Irritable Bowel Syndrome and Non Infectious Irritable Bowel Syndrome

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【作者】 杨莉丽吴慧华江丹玲邹兵王俊萍

【Author】 YANG Li-li;WU Hui-hua;JIANG Dan-ling;ZOU Bing;WANG Jun-ping※;Peking University Shenzhen Hospital;

【通讯作者】 王俊萍;

【机构】 北京大学深圳医院

【摘要】 目的:分析感染后肠易激综合征(PI–IBS)与非感染后肠易激综合征(NPI–IBS)两种疾病类型的临床特征及差异。方法:将2016年10月至2018年10月期间于北京大学深圳医院确诊并治疗的PI–IBS患者50例作为观察1组,NPI–IBS患者60例作为观察2组,选取同期在本院接受健康体检的人员50例作为对照组。所有研究对象均接受血清肠脂肪酸结合蛋白(I–FABP)指标检测及肠黏膜白细胞介素(IL)–17A、干扰素–γ(IFN–γ)、IL–10检测,比较各组差异;分析比较观察1组和观察2组的临床特征及差异。结果:观察2组患者的焦虑自评量表(SAS)评分及患病至就诊时间显著少于观察1组,差异具有统计学意义(P<0.01);观察1组和观察2组的胃肠道症状评定量表(GSRS)评分比较,差异无统计学意义(P>0.05);观察1组患者的血清I–FABP测定结果为(43.01±4.00)μg·L-1,观察2组为(18.32±1.44)μg·L-1,对照组为(10.58±1.22)μg·L-1。观察1组患者的I–FABP值显著高于观察2组和对照组,观察2组显著高于对照组,差异均具有统计学意义(P<0.01);观察1组与观察2组肠黏膜IL–17A、IFN–γ水平均显著高于对照组,差异具有统计学意义(P<0.05),但IL–10水平均明显低于对照组,差异具有统计学意义(P<0.01)。观察1组IFN–γ水平显著高于观察2组,差异具有统计学意义(P<0.05);观察1组与观察2组肠黏膜IL–17A、IL–10水平比较,差异无统计学意义(P>0.05)。结论:PI–IBS伴有焦虑状态,细胞因子的改变可能是肠道上皮细胞损伤及肠黏膜屏障功能障碍的机制之一。I–FABP有可能是PI–IBS的特异性检测指标。

【Abstract】 Objective To analyze the clinical difference between post-infection Irritable Bowel Syndrome(PI-IBS) and non infectious irritable bowel syndrome (NPI-IBS).Methods A total of 50 patients with PI-IBS as observation group 1,60 patients with NPI-IBS as observation group 2 and 50 healthy controls as control group were prospectively recruited from October 2016 to October 2018.All participants underwent serum levels of intestinal fatty acid binding protein (I-FABP) and intestinal MucosaIL-17A,IFN-γ,IL-10Test,compare the difference between the two groups as well as the comparison of clinical characteristics of the two groups.Results The self-rating anxiety scale (SAS) scores and the time from illness to treatment in the observation group 2 were significantly less than those in the observation group 1,and the difference was statistically significant (P < 0.01).There was no statistically significant difference in the Gastrointestinal Symptom Rating Scale (GSRS) scores between observation group 1 and observation group 2 (P > 0.05).The results of serum I-FABP measurement in observation group 1 were (43.01±4.00) μg/L,observation group 2 was (18.32±1.44) μg/L,and control group was (10.58±1.22) μg/L.The I-FABP value of patients in observation group 1 was significantly higher than that of observation group 2 and control group,and observation group 2 was significantly higher than that of control group,and the difference was statistically significant (P < 0.01).The intestinal mucosal IL-17A and IFN-γ levels of observation group 1 and observation group 2 were significantly higher than those of the control group,and the difference was statistically significant (P < 0.05),but the IL-10 level was significantly lower than that of the control group,and the difference was statistically significant Learning significance (P < 0.01).The level of IFN-γ in observation group 1 was significantly higher than that in observation group 2,and the difference was statistically significant (P < 0.05);compared with observation group 1 and observation group 2 intestinal mucosal IL-17A and IL-10 levels,the difference was not statistically significant (P > 0.05).ConclusionPI-IBS is associated with anxiety state,and the change of cytokines may be one of the mechanisms of intestinal epithelial cell injury and intestinal barrier dysfunction.I-FABP may be a specific indicator for PI-IBS.

【基金】 深圳科技创新委员会科技计划项目资助课题(JCYJ20140415162542973)
  • 【文献出处】 深圳中西医结合杂志 ,Shenzhen Journal of Integrated Traditional Chinese and Western Medicine , 编辑部邮箱 ,2021年09期
  • 【分类号】R574.4
  • 【被引频次】1
  • 【下载频次】68
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