功能性消化不良病人胃粘膜CGRP、SP免疫阳性纤维与胃机械感觉过敏的关系

目的　检测功能性消化不良 (FunctionalDyspepsia ,FD)病人感知阈值与胃粘膜中降钙素基因相关肽(CGRP)和P物质 (SP)关系。方法　根据感知阈值 ,将 2 3例病人分为感知正常组和感知过敏组 ;用SABC免疫组化法 ,检测近端胃粘膜中CGRP和SP免疫阳性纤维的平均光密度值 (OD值 )。结果　FD病人胃感知阈值明显较正常人下降 (P <0 .0 1 ) ;感知过敏组刺激前胃粘膜CGRP和SP阳性纤维平均OD值均明显高于其他两组 (P值均<0 .0 5 ) ,刺激后其CGRP和SP的平均OD值较刺激前均明显下降 (P值均 <0 .0 1 ) ,刺激引起CGRP和SP的释放量也均显著高于正常人及感知正常组 (P值均 <0 .0 5 ) ;刺激前CGRP和SP的平均OD值与胃感知阈值均有显著负相关 (rcgrp=- 0 6 4 8,P <0 0 1和rsp=- 0 .6 99,P <0 .0 1 ) ;刺激引起CGRP和SP释放的百分数与感知阈值也均有显著负相关 (rcgrp=- 0 .4 2 9,P <0 .0 5和rsp=- 0 .5 74 ,P <0 .0 5 )。结论　FD病人感知过敏组胃粘膜CGRP及SP阳性纤维中合成和释放CGRP、SP是增加的 ,可能与胃机械感觉过敏有关。

Role of Gastric Mucosal CGRP- and SP-immnoreactive Positive Nerve Fiber on Gastric Hypersensitivity in Patients with Non-ulcer Dyspepsia

Objective To investigate the relationship between calcitonin gene-related peptide(CGRP)- and substance P(SP)-immunoreactive fiber innervating on gastric mucosa and sensation in patients with functional dyspepsia (FD).Methods 23 FD patients were divided into two groups that including FD patients with gastric hypersensitivity group (FD-GH) and normal perception threshold group (FD-NPT) depending on the sensory threshold. The distribution of CGRP and SP nerve fibers within mucosal layer of proximal stomach was observed by immunohistochemistry staining (SABC method), and got the average optical density value of CGRP and SP immunoreactive (ir-CGRP and -SP) fibers under mitrospectrophotomefer (MSP). were measured. Results Perception threshold of proximal stomach in patients with FD significantly was lower than that in healthy volunteers (P<0.01). The OD value of ir-CGRP and -SP in FD-GH group were significantly higher compared to the healthy controls and FD-NPT group before stimulation (CGRP:P<0.01 and P<0.05, SP:P<0.01 and P<0.05,respectively).The OD values of ir-CGRP and -SP were significantly lower after distension than those before in FD-GH (P<0.01and P<0.05,respectively). The percentages of release of CGRP and SP were significantly increased in FD-GH compared to control and FD-NPT groups (CGRP:P<0.05 and P<0.05,SP:P<0.05 and P<0.05,respectively).The OD values of ir-CGRP and -SP were related to gastric perception threshold in subjects (r cgrp =-0.648, P<0 01 and r sp =-0 699, P<0.01 respectively).Correlation was found between the release percentage of CGRP or SP and gastric perception threshold (r cgrp =-0.429,P<0.05 and r sp =-0 574,P<0.05, respectively). Conclusion Patients with FD have gastric hypersensitivity to mechanical stimulation. The synthesis and release of CGRP and SP were increased in FD-GH,which was related to the gastric hypersensitivity.