【摘要】 目的　探讨结肠黏膜肥大细胞活化在肠易激综合征 (IBS)发病机制中的作用。方法　采用c Fos和类胰蛋白酶免疫组化双标方法 ,对应激和条件应激肠功能紊乱大鼠及符合罗马Ⅱ标准、连续就诊的发作期IBS患者 5 6例进行直肠乙状结肠交界处黏膜肥大细胞活化程度研究 ,并与对照大鼠和健康对照组及 2例无症状超过 6个月的IBS患者相比较 ,观察应激和条件应激大鼠在应激前 30min腹腔注射 (i.p .)肥大细胞稳定剂色甘酸二钠 2 0mg/kg对大鼠内脏敏感性的影响 ,通过Spearman等级相关分析评价IBS患者症状严重指数与肥大细胞活化分数的关系。结果　与对照组相比 ,应激 [(8.0± 0 .9)比(2 .5± 0 .8) ]和条件应激 [(7.8± 0 .8)比 (2 .5± 0 .8) ]大鼠结肠下段黏膜活化细胞明显增加 ,但肥大细胞总数无明显改变 ;色甘酸二钠显著降低应激大鼠 [(7.2± 1.2 )比 (3.8± 0 .8) ,P <0 .0 1]和条件应激大鼠[(6 .8± 0 .8)比 (3.8± 0 .8) ,P <0 .0 1]的内脏敏感性 ,对对照组大鼠却无影响。与 2 0例正常对照组相比 ,IBS发作期患者直肠乙状结肠交界处黏膜肥大细胞数目和活化细胞分数显著增加 [(85± 12 )比 (15± 6 ) ,P <0 .0 1],肥大细胞活化分数与症状严重程度指数显著相关 (r =0 .86 2 ,P <0 .0 1)。结论　肠道黏膜肥大细胞活化?更多还原

【Abstract】 Objective To explore the potential role of activation of the colonic mucosal mast cells in the pathogenesis of irritable bowel syndrome (IBS). Methods The activation of colonic mucosal mast cells was evaluated by double immunohistochemical staining with c-Fos and tryptase in restraining stress and conditioned restraining stress rats and in 56 refractory IBS patients(by Rome Ⅱ criteria), 2 free-symptom more than 6 months patients and 20 healthy controls. It was also evaluated that the effect of mast cell stabilizer sodium cromoglycate 20 mg/kg given intraperitoneally (i.p.) 30 min before stress or conditioned stress on electromyographic activity (EMG) in abdominal striated muscle as the marker of visceral sensitization. The relationship between the severity index of symptom and the percentage of activation of sigmoid-rectal mucosal mast cells in IBS was analyzed by Spearman rank correlation. Results The percentage of activating mast cells instead of the total number increased significantly in stress (2.5 ±0.8 vs. 8.0±0.9) and conditioned stress (2.5± 0.8 vs. 7.8±0.8) rats compared with that in controls ( P <0.01), respectively. Sodium cromoglycate i.p. decreased visceral sensitivity markedly in stress rats (7.2±1.2 vs. 3.8±0.8, P <0.01) and conditioned stress rats (6.8±0.8 vs. 3.8± 0.8, P < 0.01); however, no significant effect on the controls was found. The increased activation percentage of sigmoid-rectal mucosal mast cells was shown in IBS (85±12) rather than in the controls (15±6) ( P <0.01) and was closely correlated with the severity index of symptom in IBS ( r =0.862, P <0.01). Conclusions The activation of colonic mast cells is involved in the visceral sensitization and that would be an important pivot in the pathogenesis of IBS.更多还原