肠易激综合征与乙状结肠胃肠激素的关系

目的 研究胃肠激素在肠易激综合征(IBS)患者乙状结肠黏膜含量的变化及临床意义. 方法 采用放射免疫法测定正常对照组(13例)及IBS惠者(便秘型、腹泻型各13倒)乙状结肠黏膜胃动素(MTL)、血管活性肠肽(VIP)、生长抑素(SS)、胆囊收缩素(CCK)的含量. 结果 腹泻型IBS乙状结肠黏膜中MTL含量显著高于便秘型IBS及正常组(P＜0.01);便秘型IBS乙状结肠黏膜VIP与SS的含量高于腹泻型IBS及正常组(P＜0.05);CCK在各组中无明显不同(P＞0.05). 结论 胃肠激素可能在IBS的发病过程中有一定作用.     

肠易激综合征患者乙状结肠动力及胃肠激素变化的研究

目的 :研究肠易激综合征 (IBS)患者乙状结肠动力及其血浆、乙状结肠黏膜中胃肠激素含量的变化及临床意义。方法 :符合 Rome II诊断标准的便秘型、腹泻型 IBS患者及对照组各 1 3例 ,分别采用液体灌注测压法记录空腹和进餐状态下乙状结肠的压力波形 ;采用放射免疫法测定血浆和乙状结肠黏膜胃动素 (MTL)、血管活性肠肽 (VIP)、生长抑素 (SS)、胆囊收缩素(CCK)含量。结果 :在空腹状态下 ,腹泻型 IBS组乙状结肠动力指数 (1 5 .9± 4 .9)显著高于便秘型 IBS组 (1 0 .9± 5 .6 )和对照组(9.4± 3.6 ) ,进食后 30 min内 ,对照组的乙状结肠动力指数 (2 1 8.7± 76 .5 )升高的幅度更为显著 ,腹泻组的动力指数 (86 .5±5 3.4 )改变幅度也显著高于便秘组 (4 2 .4± 2 9.6 )。试餐后第 6 0分钟 ,腹泻型 IBS组乙状结肠动力指数 (6 5 .4± 1 1 .7)升高的幅度显著高于便秘组 (1 9.8± 1 4 .5 )和对照组 (2 3.2± 1 1 .3)。腹泻型 IBS患者血浆及乙状结肠黏膜中 MTL 含量显著高于对照组及 IBS便秘型患者 (P <0 .0 1 ) ;便秘型 IBS患者乙状结肠黏膜 VIP的含量高于正常组及腹泻型 IBS(P <0 .0 5 ) ,而血浆中VIP各组间差异无统计学意义 (P >0 .0 5 ) ;血浆及乙状结肠黏膜 SS的含量在便秘型 IBS中显著高于对照组及腹泻型 (P <0     

结肠水疗对便秘型IBS患者胃肠激素影响的相关性研究

目的研究结肠水疗前后便秘型肠易激综合征患者血浆、乙状结肠黏膜中胃肠激素含量的变化及其关系。方法便秘型IBS患者15例,予结肠水疗3次/周,疗程为4周,治疗前后采用放射免疫法测定血浆和乙状结肠黏膜胃动素(MTL)、血管活性肠肽(VIP)、生长抑素(SS)含量。结果治疗前,便秘型IBS患者乙状结肠黏膜MTL、VIP、SS以及血浆中VIP、SS的含量均高于正常组,差异有统计学意义(P<0.05)。血浆中MTL两组间差异无统计学意义(P>0.05)。治疗后,便秘型IBS患者乙状结肠黏膜MTL、VIP、SS的含量较之治疗前均有所下降,差异无统计学意义(P>0.05)。结论结肠水疗治疗便秘型IBS可能通过调节患者乙状结肠黏膜的胃肠激素水平,而达到较好的临床疗效。     

肠易激综合征结肠动力与胃肠激素的相关性研究

目的　研究肠易激综合征患者乙状结肠动力及其血浆、乙状结肠黏膜中胃肠激素含量的变化及其关系。方法　便秘型、腹泻型IBS组及对照组各13名,分别采用液体灌注测压法记录空腹和进餐状态下乙状结肠的压力波形;采用放射免疫法测定血浆和乙状结肠黏膜胃动素(MTL)、血管活性肠肽(VIP)、生长抑素(SS)、胆囊收缩素(CCK)含量。结果　在空腹状态下,腹泻组乙状结肠动力指数(15.9±4.9)显著高于便秘组(10.9±5.6)和对照组(9 .4±3.6);进食后30 min内,对照组的乙状结肠动力指数(218. 7±76. 5)升高的幅度更为显著,腹泻组的动力指数(86. 5±53. 4)显著高于便秘组(42 4±29 6)。试餐后60 min,腹泻组乙状结肠动力指数(65. 4±11. 7),显著高于便秘组(19 8±14 .5)和对照组(23 .2±11 .3)。腹泻组血浆及乙状结肠黏膜中MTL含量显著高于对照组及便秘组患者(P<0 .01);便秘组乙状结肠粘膜VIP的含量高于正常组及腹泻组(P<0 .05),血浆中VIP各组间无明显差异(P>0 .05);血浆及乙状结肠黏膜SS的含量在便秘组中显著高于对照组及腹泻组(P<0 .01~0 05);血浆CCK在腹泻组也明显高于对照组及便秘组(P<0. 05),在乙状结肠黏膜中各组间差异无显著性(P>0. 05)。空腹状态,乙状结肠黏膜MTL、CCK的含量与腹泻组乙状结肠动力指数呈正相关关系(r=     

胃肠肽类激素与肠易激综合征发病间的关系

目的:研究肠易激综合征(IBS)患者血浆和乙状结肠黏膜组织中胃肠肽类激素的含量变化与肠易激综合征发病间的关系。方法:用放射免疫法分别检测IBS患者(40例)和正常对照组(15例)血浆及乙状结肠黏膜组织中胆囊收缩素(CCK)、血管活性肠肽(VIP)、生长抑素(SS)、P物质(SP)、酪神经肽(NPY)5种胃肠激素的含量。结果:①与正常对照组相比,IBS患者血浆中CCK含量明显升高(P<0.05),NPY含量减低(P<0.05),SS、VIP和SP含量变化差异无显著性(P>0.05)。②与正常对照组相比,IBS患者肠黏膜组织中VIP和SP含量均升高(P<0.01),NPY减低(P<0.05)而SS和CCK含量变化差异无显著性(P>0.05)。结论:IBS患者血浆或乙状结肠黏膜中CCK、VIP、SP、NPY的变化在IBS的发病中有一定的作用。     

肠激惹综合征患者体表小肠电及血浆胆囊收缩素检测意义的研究

目的：检测肠激惹综合征（IBS)患体表生物电及血浆胆曩收缩素(CCK)浓度．探讨它们与IBS病人症状的关系及可能作用。方法：正常对照组与IBS组均在仰卧、安静、禁食，固定时间、消除外界干扰情况下提取体表小畅电：血浆CCK的定均在问一标准下进行：统计学方法采用正态D检验．两样本方差异性检验及t检验。结果．本研究显示正常人与IBS患体表小肠电优势频率无显差异．血浆CCK浓度．IBS组明显高于对照组。结沦：可望通过检测血浆中的CCK浓度做为诊断IBS的参数．但仍需进一步观察验证。     

观音合剂治疗肺脾气虚型小儿厌食症的临床研究

目的 观察观音合剂治疗小儿厌食症(肺脾气虚型)的临床疗效,探讨观音合剂治疗小儿厌食症的作用机制.方法 选取肺脾气虚型的厌食症患儿42例分为两组,分别用观音合剂和参苓白术合剂治疗,并运用放免检测技术测定血清瘦素(Leptin)和血浆胆囊收缩素(CCK)的含量.结果 观音合剂组疗效优于参苓白术合剂组(P<0.05).两组血清Leptin含量及血浆CCK含量治疗前后比较均有显著变化(P<0.01);两组对血清Leptin含量升高作用相仿(P>0.05);观音合剂组对血浆CCK含量降低作用优于参苓白术合剂组(P<0.05).结论 观音合剂能有效改善患儿厌食症状;能通过调节厌食症患儿血清Leptin和血浆CCK水平对食欲产生影响.     

中药白术对肝硬化大鼠肠动力及胃肠激素的影响

目的:观察中药白术对肝硬化大鼠肠道动力及其胃肠激素分泌的影响,探讨其可能的作用机制.方法:24只Wistar大鼠随机分为肝硬化模型组、肝硬化中药治疗组和正常对照组,采用葡聚糖蓝-2000为胃肠内标记物,观察大鼠肠道传输的变化,同时测定大鼠血浆、肠道组织中胃动素(MTL)、胆囊收缩素(CCK)、血管活性肠肽(VIP)及生长抑素(SS)含量的变化.结果:与对照组比较,肝硬化模型组大鼠小肠动力显著减弱(P<0.01),血浆及空肠组织中MTL、VIP、SS的含量明显增加(P<0.01,P<0.05),CCK的含量则显著减少(P<0.01);肝硬化中药治疗组大鼠小肠动力与对照组比较无明显差异,血浆及空肠组织中MTL、VIP、SS的含量与对照组比较无明显变化,CCK的含量则与肝硬化模型组无显著差异.结论:中药白术对肝硬化大鼠小肠运动功能减退有明显改善作用,其机制可能与MTL、VIP、SS的变化有关.     

IBS患者肠粘膜P物质的表达及其与焦虑、抑郁的相关性研究

目的 探讨P物质(Substance P)的表达及其与肠易激综合征(IBS)患者焦虑、抑郁的关联.方法 采用SCL-90量表对IBS患者和正常对照组进行测试,评定心理状况;采用免疫组化法分析IBS患者及正常对照组乙状结肠和回盲部粘膜P物质的含量.结果 IBS患者存在明显的焦虑、抑郁、敌对负性情感;IBS腹泻型患者结肠粘膜中P物质的表达显著高于正常组及IBS便秘型组(P＜0.01);IBS患者焦虑、抑郁与乙状结肠和回盲部粘膜P物质的表达相关.结论 肠易激综合征患者焦虑、抑郁与结肠黏膜P物质的表达相关.     

IBS患者肠粘膜P物质的表达及其与焦虑、抑郁的相关性研究

目的 探讨P物质(Substance P)的表达及其与肠易激综合征(IBS)患者焦虑、抑郁的关联.方法 采用SCL-90量表对IBS患者和正常对照组进行测试,评定心理状况;采用免疫组化法分析IBS患者及正常对照组乙状结肠和回盲部粘膜P物质的含量.结果 IBS患者存在明显的焦虑、抑郁、敌对负性情感;IBS腹泻型患者结肠粘膜中P物质的表达显著高于正常组及IBS便秘型组(P＜0.01);IBS患者焦虑、抑郁与乙状结肠和回盲部粘膜P物质的表达相关.结论 肠易激综合征患者焦虑、抑郁与结肠黏膜P物质的表达相关.     

肠易激综合征患者肠道电活动和胃肠激素

目的：探讨肠易激综合征（ＩＢＳ）肠道电活动和胃肠激素间的关系,以及它们在ＩＢＳ中的作用．方法：采用对照组（ｎ＝２４）和ＩＢＳ组（ｎ＝２６）对比研究．肠生物电检测通过自适应滤波和功率谱分析,胃肠激素检测采用放射免疫分析法．结果：ＩＢＳ组小肠、结肠电活动的主频率（周次／ｍｉｎ）分别为１０￣１２和４￣７,与对照组比较无明显变化（Ｐ〉０．０５）;ＩＢＳ组血浆中胆囊收缩素（ＣＣＫ）、胃动素和生长抑素（ＳＳ）     

加味参苓白术散治疗腹泻型肠易激综合征的临床疗效及对脑肠肽水平的影响

目的 探讨加味参苓白术散治疗腹泻型肠易激综合征(irritable bowel syndrome with pre-dominant diarrhea,IBS-D)的临床疗效及对患者脑肠肽水平的影响.方法 选取117例IBS-D患者进行研究,采用随机数字表法分为观察组和对照组.对照组58例予匹维溴铵片、酪酸梭菌活菌胶囊...     

腹泻型肠易激综合征患者血中CD3+,CD4+,CD8+T淋巴细胞变化的观察

目的探讨免疫因素与腹泻型肠易激综合征(IBS)的关系.方法用APAAP法检测32例IBS患者和30例健康对照者的外周血T淋巴细胞亚群,并对二者进行比较观察.结果IBS患者外周血CD3值与健康对照组无差别(P＞0.05),CD4值明显低于对照组(P＜0.05),CD8值明显高于对照组(P＜0.05),CD4/CD8比值下降(P＜0.05).结论IBS的腹泻型可能与免疫改变有关.     

迁延性及慢性腹泻患儿血中胃泌素、胃动素和生长抑素水平

应用放免法测定 2 8例迁延性及慢性腹泻患儿治疗前、恢复期和 2 2例正常儿童的晨空腹及餐后 1h血中的胃泌素 (GAS)、胃动素 (MOT)和生长抑素 (SS)的水平 ,并进行相关分析。结果显示 :患儿治疗前、恢复期及对照组餐后血中的 GAS、MOT和 SS水平明显高于空腹时 (P<0 .0 1) ;治疗前空腹和餐后的血清 GAS、血浆 MOT水平及空腹的血浆 SS水平高于恢复期和对照组 (P<0 .0 5 ,0 .0 1) ,但餐后 SS水平无显著差异 (P>0 .0 5 ) ;患儿治疗前 GAS/SS和 MOT/ SS的比值增大 ,与恢复期和正常儿童比较差异极显著 (P<0 .0 5 ,0 .0 1)。恢复期和对照组血中 GAS与 SS和 MOT与 SS呈正相关 ,但治疗前则无相关。结果提示 ,腹泻迁延不愈可能与 GAS、 MOT和 SS分泌异常相关联     

肠易激综合征患者内脏高敏感性与肥大细胞的关系

目的：探讨肠易激综合征（IBS）患者肠黏膜肥大细胞（MC）在内脏高敏感机制中的可能作用和临床意义。方法：应用电子气压泵及灌注导管测压仪检测22例腹泻型IBS（D－IBS）患者、20例便秘型IBS（C－IBS）患者和19例正常人肛门直肠压力、直肠对容量刺激的感觉及直肠顺应性。取回肠末端、回盲部、升结肠、乙状结肠黏膜标本，应用特殊组化染色法（甲苯胺蓝改良染色法）对MC染色，并应用彩色病理图像分析软件进行分析。结果：IBS患者肛门直肠括约肌的静息压、收缩压、松弛压与正常人相似（P＞0．05）；感觉阈值、排便阈值、疼痛阈值明显低于正常人（P＜0．01）；直肠顺应性降低（P＜0．01）；向直肠内注气20或40ml后，均可引起直肠肛门抑制性反射。IBS患者回肠末端、回盲部、升结肠MC明显增多（P＜0．01），且D－IBS和C－IBS组间也有明显差异（P＜0．01），而乙状结肠MC在各组间均无明显变化。结论：IBS患者MC存在变异，MC在IBS内脏高敏感的病理生理过程中可能具有重要作用。     

EFFECTS OF ENTERAL AND PARENTERAL NUTRITION ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY

Objective To investigate the effects of enteral nutrition （EN） and parenteral nutrition （PN） on gastric motility and gastroentefic hormones after subtotal gastrectomy. Methods Forty-one patients underwent gastrectomy were randomly divided into EN group （n=20） and PN group （n=21 ）. From the first postoperative day to the seventh day, patients received either EN （EN group） or PN （PN group） with isocalofic （84.9kJ·kg^-1·d^-1） and isonitrogenous （0.11g·kg^-1·d^-1） intake. Serum gastrin （GAS）, plasma mofilin （MTL）, and plasma cholecystokinin （CCK） were measured on preoperative day, the first and seventh postoperative day. Electrogastrography （EGG） was measured on preoperative day and the seventh postoperative day. Results Compared with preoperafion, blood GAS, MTL, and CCK levels of 41 patients decreased significantly on the first day after subtotal gastrectomy （ P 〈 0. 001 ）, but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained （ P 〈 0. 001 ）. On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group （ P 〈 0.05 ）. There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper- atively. Conclusions The levels of gastroentefitic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.     

胃动素和胆囊收缩素与肠易激综合征的关系

目的探讨肠易激综合征(irritable bowel syndrome,IBS)与胃动素(motilin,MOT)、胆囊收缩素(chole     

EFFECT OF ERYTHROMYCIN ON GASTRIC DYSMOTILITY AND NEUROENDOCRINE PEPTIDES IN RATS WITH DIABETES MELLITUS

Objective To investigate the effect of erythromycin on the contractive activity of the isolated gastric antrum smooth muscle and somatostatin (SS), vasoactive intestinal peptide (VIP), motilin (MTL), and substance P (SP) in plasma and isolated gastric antrum tissue of diabetes mellitus (DM) rat models. Methods Thirty male Sprague-Dawley rats were divided into three groups: control group (n = 10), DM group (n =10), and erythromycin group (DM models with erythromycin treatment, n = 10). A single dose of streptozotocin (100 mg/kg,dissolved in 0.1 mol/L citric acid buffer, pH4.5) was injected intraperitoneally. After 48 to 72 hours, rats with blood glucose above 16.7 mmol/L and urine glucose level to be ( ) to ( ) over one week were considered successful DM models. The resting tension, mean contractile amplitude and frequency of spontaneous change in isolated longitudinal and circular gastric antrum smooth muscle strips were measured. SS, VIP, MTL, and SP levels in plasma and gastric antrum tissue were measured using radioimmunoassay. Results (1) In the isolated gastric antrum smooth muscle strips, the gastric motility parameters were lower in DM group than those in control group except circular smooth muscle contractile amplitude and longitudinal smooth muscle contractile frequency. The gastric motility parameters were significantly strengthened in erythromycin group, compared with DM group except longitudinal smooth muscle resting tension (P ＜ 0.01). (2) Plasma SS, VIP, and MTL concentrations in DM group were higher than those in control (P ＜ 0.05), while the SP level decreased (P ＜ 0.05). In the gastric antrum, SS of DM group was significantly higher than that of control group (P ＜ 0.01), while SP and MTL levels were lower than those of control group (P ＜ 0.05 and P ＜ 0.01, respectively). However, the level of VIP in gastric antrum tissue did not change among three groups. The plasma level of SS in erythromycin group was higher than that of DM group(P＜ 0.05). (3) The blood glucose was lower in erythromycin group than DM group (P ＜ 0.01).Conclusions Erythromycin has direct effects on contractive activity of gastric smooth muscle in diabetic rats, but there are few effects on neuroendocrine peptides. Gastric-motility disorders in diabetic rats have a correlation with the changes of neuroendocrine peptide levels in plasma and gastric antrum tissue.     

Expression of intestinal mucosa tight junctions claudin proteins and mRNA in patients with irritable bowel syndrome

Objective：To investigate the changes of intestinal mucosa tight junctions （TJs） claudin-1, -3, -4 proteins and mRNA changes in patients with irritable bowel syndrome （IBS） and to elucidate their possible roles in the changes of bowel evacuation habit and formation. Methods： Claudin-1, -3, -4 proteins and mRNA were evaluated in intestinal mucosa in control group, D-IBS （diarrhea IBS） group and C-IBS （constipation IBS） group with immunohistochemical assay and Realtime-PCR. Results： It was observed that claudin-1, -3, -4 proteins were localized in the membranes of epithelial cells along the entire length of the plasma membrane including the apical end of the epithelial cells. The elaudins were concentrated at the site of TJs only. Claudin-1, 3, -4 mRNA and claudin-1 protein in small intestinal mucosa and colonal mucous in D-IBS group were significantly downregulated （P〈0.05）. Claudin-1, -3, -4 mRNA and proteins in small intestinal mucosa and colonal mucous in C-IBS group were significantly upregulated （P〈0. 05）. There was no significant difference in the expression of claudin-3 protein in both small intestinal mueosa and colonal mucous between D-IBS group and control group（P〉0.05）. Similarly, no significantly different expression of claudin-4 protein in colonal mucous in D-IBS group was found compared with control group （P〉0.05）. Otherwise, the expression of claudin 4 protein in small intestinal mucosa decreased in D-IBS group （P〈0.05）. Conclusion： Claudin-1, -3, -4 may play a potential important role in the changes of bowel evacuation habit and formation in patients with IBS. It is not due to the localization changes of claudin proteins in TJ, but may be caused by the quantitative changes of the expression of TJ proteins and mRNA.