肥大细胞在胃感觉过敏患者胃黏膜中的改变

目的：了解国人功能性消化不良（FD）患者是否存在胃机械感觉过敏，对胃感觉过敏患者胃黏膜肥大细胞数量及脱颗粒情况进行研究，探讨肥大细胞在胃感觉过敏中的作用。方法：运用电子恒压器测定40例FD患者和15例正常人的胃感觉阈值。根据感知阈值将23例FD患者分为两组：感觉正常组（FD－N）和感觉过敏组（FD－H）。免疫组化方法染色肥大细胞，计数肥大细胞数；图像分析了解肥大细胞在扩张刺激前后平均吸光度值（A）的变化；电镜观察大细胞超微结构改变。结果：FD患者对胃机械扩张刺激的感知阈值，不适阀值，疼痛阈值均较正常人显著下降（P＜0．01，P＜0．01，P＜0．05），感觉过敏感患者近端胃黏膜肥大细胞数量明显多于FD－N组和对照组（P＜0．05）。刺激前后感觉过敏患者肥大细胞平均A值减少百分数较FD－N组和对照组明显增多（P＜0．05），电镜观察到肥大细胞与神经末梢关系密切，肥大细胞释放的颗粒有向神经末梢靠扰趋势。结论：部分FD患者存在胃机械感觉过敏；胃感觉过敏与胃黏膜肥大细胞数量增多，脱颗粒增加有关。

Change of mast cell in gastric mucosa of patients with gastric hypersensitivity

Objective To investigate whether gastric hypersensitivity exists in functional dyspepsia patients, and to observe the number of mast cells in proximal gastric mucosa in gastric hypersensitivity patients and the change of mast cell degranulation after stimulation so as to evaluate the role of mast cells in gastric hypersensitivity. Methods Gastric sensation threshold was determined using barostat in 40 functional dyspepsia (FD) patients and 15 controls. Twenty three patients were divided into two groups on the basis of perception threshold: hypersensitivity group (FD H) and normal sensation group (FD N). Mast cells were stained by immunohistochemistry method, mast cell number was calculated by microscopy and the average optical density valves( A ) of mast cell were obtained by microspectrophotometry (MSP). The ultrastructure of mast cell was observed under electromicroscopy. Results Gastric sensation threshold (i.e. perception, discomfort and pain threshold) was significantly lower in FD patients than in controls ( P <0.01, P <0.01 and P <0.05). Mast cell number in proximal gastric mucosa in FD H was significantly greater than that in FD N and controls ( P <0.05). The reduced percent of mast cell A after stimulation was significantly greater in FD H than that in FD N and controls ( P <0.05). Mast cells had an intimate relation to afferent nerves and the granules released by mast cells were close to nerve endings. Conclusions Gastric hypersensitivity exists in a parts of FD patients and may be correlated with the increase of the number and of the degranulation of mast cells in gastric mucosa.