1. 1. 重庆医科大学附属第一医院消化内科,重庆,400016
2. 海南省人民医院消化内科,海南,海口,570311
3. 绵阳市第三人民医院,四川,绵阳,621000
网络首发:2017-03-16,
纸质出版:2017
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代迎欢, 蓝程, 刘丹, 等. 感染后肠易激综合征患者临床特征和细胞因子的表达[J]. 中山大学学报(医学科学版), 2017,38(2).
DAI Ying-huan, LAN Cheng, LIU Dan, et al. Clinical Features and Expression of Cytokine in Post-infectious Irritable Bowel Syndrome Patients[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(2).
【目的】探讨感染后肠易激综合征(PI-IBS)和非感染后肠易激综合征(NPI-IBS)患者临床特征及肠黏膜、外周 血IL-17A、IFN-γ和IL-10 的表达。【方法】腹泻型IBS 患者44 例(PI-IBS 21 例,NPI-IBS 23 例),健康对照者10 例,采用 GSRS、SAS、SDS量表评估肠易激综合征患者胃肠道症状、焦虑及抑郁状态。肠镜下取回盲部及直肠黏膜标本,免疫组化法 检测IL-17A、IFN-γ和IL-10的表达。ELISA法检测外周血IL-17A、IFN-γ和IL-10的表达。【结果】NPI-IBS 患者较对照组 SDS评分升高(P < 0.05);PI-IBS患者较对照组SAS和SDS评分升高(P < 0.05);PI-IBS组较NPI-IBS组GSRS、SAS和SDS评 分显著升高(P < 0.05);与对照组相比,PI-IBS组和NPI-IBS组回盲部和直肠IL-17A、IFN-γ的表达升高,IL-10的表达降低 (P < 0.05);PI-IBS 组血清中IL-17A 的表达较对照组升高,IL-10 的表达降低(P < 0.05);肠黏膜和外周血中PI-IBS 组IL- 17A和IFN-γ的表达较NPI-IBS组稍高,但差异无统计学意义(P > 0.05)。【结论】PI-IBS和NPI-IBS患者存在不同程度的焦 虑、抑郁表现,外周血和肠黏膜中IL-17A和IFN-γ的表达升高,IL-10表达降低,但PI-IBS患者临床症状相对较重,细胞因 子的改变更明显,PI-IBS可能与NPI-IBS有不同的发病机制。
Abstract:【Objective】To study the clinical features and expressions of IL-17A,IFN-γ,and IL-10 in serum and intestinal mucosa of patients with post-infectious irritable bowel syndrome and non post-infectious irritable bowel syndrome.【Methods】44 diar? rhea-predominate IBS patients(21 with PI-IBS,23 with NPI-IBS)and 10 healthy controls were recruited in this study. Investigation questionnaires of GSRS,SAS,SDS were carried out to evaluate the gastrointestinal function,anxiety status and depression status of IBS patients. The expressions of IL-17A,IFN-γ,and IL-10 in intestinal mucosa and serum were measured by immunohistochemis? try(IHC)and enzyme-linked immunosorbent assay(ELISA).【Results】The SDS scores of NPI-IBS patients were higher than those of controls(P < 0.05),and the SAS and SDS scores of PI-IBS patients were higher than those of controls(P < 0.05). The GSRS, SAS and SDS scores of PI-IBS group were higher than those of NPI-IBS group(P < 0.05). Compared with healthy controls,PI-IBS and NPI-IBS group showed significant rise of IL-17A,IFN-γ levels and decrease of IL-10 level in intestinal mucosa(P < 0.05);In serum,the IL-17A levels were up-regulated and the IL-10 levels were decreased in PI-IBS group but not in NPI-IBS group whenthan those in NPI-IBS group(P > 0.05).【Conclusion】PI-IBS and NPI-IBS patients existed various anxiety and depression. The levels of IL-17A and IFN-γ increased and level of IL-10 decreased in PI-IBS and NPI-IBS group. But the clinical symptoms and changes of cytokines of PI-IBS patients were more significant. There may exist other pathogenesis in PI-IBS but not in NPI-IBS.
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