肠黏膜雌孕激素受体表达在肠易激综合征发病机制中的作用研究

目的 探讨雌、孕激素受体在肠易激综合征（IBS）患者肠道内分布、变化及其临床意义，并对在消化道的作用靶点和可能的细胞学机制做出合理解释和推断。方法 经结肠镜钳取24名正常人和59例肠易激综合征患者的回肠末端、盲肠和降结肠黏膜，分别采用抗人雌、孕激素受体抗体标识肠黏膜上雌、孕激素受体，并应用免疫组化方法检测了雌、孕激素受体阳性细胞数目改变。结果 1、IBS患者回肠末端和盲肠黏膜雌激素受体阳性细胞数目增多（P＜0.01)，降结肠黏膜与正常组无显著差别；2、肠道黏膜未见孕激素受体表达 结论 IBS患者肠黏膜雌激素受体高表达在IBS病理过程中发挥一定作用，并认为肥大细胞为雌激素在消化道的重要靶点，其对于揭示IBS在女性中的高发病率和月经期加重的临床现象有重要意义；同时提示雌激素受体拮抗剂可能对部分患者有效。

The functional research of expression of estrogen receptors and progestogen receptors of intestinal mucosa in the irritable bowel syndrome pathogenesis

Aim To investigate the intestinal distribution,intestinal change and clinical significances of estrogen receptors (ER) and progestogen receptors (PR) in patiens with irritable bowel syndrome (IBS) and interpret and infer reasonably their targets and their possible cytology mechanism.Methods Biopsies from 59 patients with IBS and 24 control persons were acquired by colonic scope and checked for the number of the positive cells for estrogen receptors(ER) and progestogen receptors(PR) in terminal ileum,caecum and decendign colon(DC)with immunohistochemical methods,which were used with mouse monoclonal antibodies against human estrogen receptors(ER) and progestogen receptors(PR).Results The number of the positive cells for ER in terminal ileum and caecum was significantly elevated in the IBS patients ( P<0.01), but there isn't signiticantly difference in the number of the positive cells for ER in descending colon mucosa in patients with IBS compared with that of the controls.While there were no expression of PR in intestine mucosa.Conclusions High enteric express of ER in the intestinal mucosa of the IBS patients has particular effect on the pathological process of IBS and mast cells are regarded as the important targets of ER in the digestive tract.It may help to explain why IBS occurs primarily in women and symptoms associated with IBS tend to be worst during the menstrual cycle.The antagonists of estrogen receptors may have treatment effects on some IBS patients.