食物过敏和十二指肠肥大细胞在功能性消化不良中的关系研究

目的探讨食物过敏及十二指肠肥大细胞对功能性消化不良(functional dyspepsia,FD)的影响及其关系。方法选取2012年1月-2013年12月重庆市北部新区第一人民医院门诊接诊的58例FD患者为观察组,另选取50名健康志愿者为对照组。对两组消化情况进行评分,并于胃镜下取两组十二指肠降段黏膜及球部组织标本。应用ELISA法测定FD患者及健康志愿者血清中14种食物过敏原特异性抗体IgG。甲苯胺蓝染色组织样本并计算肥大细胞总数及脱颗粒肥大细胞所占比例。结果与对照组相比,FD组上腹疼痛、早饱、上腹胀及上腹烧灼感评分显著升高,差异有统计学意义(P0.05)。与对照组相比,FD组十二指肠降段黏膜及球部肥大细胞数量及脱颗粒肥大细胞百分比显著升高,差异有统计学意义(P0.05)。经Pearson相关因素分析,十二指肠降段黏膜及球部肥大细胞总数及脱颗粒肥大细胞比例与各症状评分无相关性(P0.05);FD组牛肉、大豆、虾、小麦的特异性抗体IgG阳性率高于对照组(P0.05);FD组IgG阳性评分高于对照组(P0.05)。经Pearson相关因素分析,IgG阳性评分与症状评分无相关性(P0.05),与十二指肠降段黏膜肥大细胞总数及脱颗粒细胞无相关性(P0.05),而与十二指肠球部黏膜肥大细胞数量及脱颗粒细胞比例呈正相关(P0.05)。结论 FD发病与特异性抗体IgG阳性表达、十二指肠脱粒肥大细胞比例升高及黏膜肥大细胞数量增多有关。

Relationship between food allergy and mast cells in functional dyspepsia

Objective To investigate the effects and relationship between food allergy and duodenal mast cells in functional dyspepsia （FD）.Methods Fifty-eight FD patients were selected for observation group,50 healthy volunteers were selected for control group from Jan.2012 to Dec.2013.The digestive condition of two groups were scored.The descending part of duodenum mucosa and bulb tissues were taken under gastroscope.The food allergen-specific IgG antibodies of two groups were measured by ELISA.The tissue samples of two groups were stained and the total number of mast cells and degranulation mast cell proportion were calculated.Results The scores of epigastric pain,early satiety,bloating and upper abdominal burning sensation of FD group were higher than those of control group （P ＜ 0.05）.The number of mast cells and the percentage of degraunlation mast in the descending part and bulb part of duobdemum cells of FD group were higher than those of control group （P ＜ 0.05）.The total number of the descending part and bulb part of the mast cells and degrconlation mast cells were not related with each symptom score （P ＞ 0.05）.The IgG positive rates of beef,soy,shrimp,wheat of FD group were higher than those of control group （P ＜ 0.05）.The IgG positive score of FD group was higher than that of control group （P ＜ 0.05）.IgG positive score was not related with the descending part of duodenum and degranulation mast cells in the total number of mast cells （P ＞ 0.05）,but related with bulb mast cells number and proportion of granulosa cells （P ＜ 0.05）.Conclusion FD incidence is ralated with specific antibody positive IgG,increased proportion duodenal degranulation mast cells increased number of mucosal mast cells.