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目的:探讨肠易激综合征(IBS)患者肠黏膜肥大细胞(MC)对内脏敏感性改变的作用及其临床意义。方法:分别检测50例IBS患者和20例正常对照组患者的肛门直肠括约肌静息压、最大收缩压和括约肌松弛压,再分别取样各患者回肠末端、回盲部、升结肠和乙状结肠处的4块黏膜标本,采用甲苯胺蓝改良染色法进行MC染色并分析其密度。结果:IBS患者肛门直肠括约肌的静息压、最大收缩压和松弛压与正常对照组比较差异无统计学意义(P>0.05);感觉阈值、疼痛阈值和排便阈值均显著低于正常对照组(P<0.05);IBS组患者回肠末端、回盲部以及升结肠黏膜MC密度均显著高于正常对照组(P<0.05);腹泻型IBS组患者回肠末端、回盲部以及升结肠黏膜MC密度均显著高于便秘型IBS组(P<0.05)。结论:IBS患者肠黏膜MC存在显著异常,可能对IBS内脏高敏感性的形成具有重要作用。
Objective: To investigate the effect of intestinal mucosal mast cells (MC) on visceral sensitivity in patients with irritable bowel syndrome (IBS) and its clinical significance. Methods: The resting pressure, the maximum systolic pressure and the sphincter relaxation pressure in anus and rectus sphincter of 50 patients with IBS and 20 normal controls were measured respectively. Then the end of ileum, ileocecal region, ascending colon and sigmoid colon of each patient were sampled Mass mucosa specimens were stained with toluidine blue staining and analyzed for their density. Results: The resting pressure, maximum systolic pressure and relaxation pressure of anorectal sphincter in IBS patients were not significantly different from those in normal control group (P> 0.05). The sensory threshold, pain threshold and defecation threshold were significantly lower than those in normal control group (P <0.05). The density of ileum, ileocecal region and ascending colon mucosa in IBS group were significantly higher than those in normal control group (P <0.05). In IBS group, the ileum, ileocecal region and ascending colon mucosa MC density Were significantly higher than the constipation type IBS group (P <0.05). Conclusion: There is a significant abnormality of intestinal mucosa in IBS patients, which may play an important role in the formation of IBS visceral hypersensitivity.