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目的探讨女性腹泻型肠易激综合,征(IBS)患者冷刺激前后5-羟色胺(5-HT)释放与症状发牛间的关系,旨在阐明冷刺激诱发IBS症状过程中的5-HT机制。方法共纳入32例女性腹泻型IBS患者和21名女性健康对照者。应用高效液相色谱法测定受试者空腹时及饮用220ml 37℃温水、同体积,4℃冷水后30、60、90、120、150、180min时血浆(去除血小板)中5-HT、5-羟吲哚乙酸(5-HIAA)浓度。同时问卷凋查所有受试者腹痛/腹部小适、腹胀、腹泻等症状的发牛情况,并对其严重程度进行评分。结果空腹状态下,腹泻型IBS患者和健康对照者血浆5-HT和5-HIAA浓度差异无统汁学意义(P>0.05)。饮冰水后30min[(48.65±11.03)比(35.52±6.29)nmol/L]、60min[(62.79±11.58)比(40.99±6.18)nmol/L]、90min[(69.56±9.26)比(45.48±6.33)nmol/L]、120min[(58.64±25.00)比(38.73±6.40)nmol/L]、150min[(46.59±7.96)比(34.43±5.79)nmol/L]时腹泻型IBS患者血浆5-HT浓度显著升商(P值均<0.05),5-HIAA浓发与5-HT呈伴行改变,5-HT代谢率(5-HIAA:5-HT)无明显变化,5-HT及5-HIAA峰值浓度及曲线下面积明显升高(P<0.01)。饮温水时则无以上差异。饮冷水后19例腹泻型IBS患者出现腹痛或腹部不适、腹胀、排便急迫感和(或)腹泻等症状,其血浆5-HT、浓度较未发生以上症状的患者明显升高,且其5-HT浓度与症状严重程度呈正相关(r=0.714,P-0.001)。结论女性腹泻型IBS患者进冷食后症状加剧可能与血浆5-HT水平升高有关。
Objective To investigate the relationship between the release of 5-hydroxytryptamine (5-HT) before and after cold stimulation in female diarrhea-predominant irritable bowel syndrome (IBS) patients and the onset of symptoms. The aim is to elucidate the mechanism of 5-HT in cold-stimulated IBS . Methods A total of 32 female IBS patients and 21 healthy controls were included. High-performance liquid chromatography (HPLC) was used to determine the content of 5-HT, 5-HT in plasma (removing platelets) at the time of fasting and drinking 220ml 37 ℃ warm water at the same volume and cold water at 4 ℃ for 30,60,90,120,150,180min. Oxindole acetic acid (5-HIAA) concentration. At the same time, the questionnaire was used to investigate the incidence of abdominal pain, abdominal distention, abdominal distention and diarrhea in all the subjects, and the severity was scored. Results There was no significant difference in plasma concentrations of 5-HT and 5-HIAA between diarrhea-predominant IBS patients and healthy controls (P> 0.05). (48.65 ± 11.03) vs (35.52 ± 6.29) nmol / L], 60min [(62.79 ± 11.58) vs (40.99 ± 6.18) nmol / L], 90min [(69.56 ± 9.26) (P <0.05), and the plasma levels of plasma 5 (P <0.05) were significantly higher in patients with diarrhea-predominant IBS (P <0.05). The concentration of 5-HIAA and 5-HT were accompanied by changes in 5-HIAA: 5-HT and 5-HT 5-HIAA peak concentration and area under the curve were significantly increased (P <0.01). No difference when drinking warm water. After drinking cold water, 19 cases of diarrhea-type IBS patients with abdominal pain or abdominal discomfort, abdominal distension, urgency and / or diarrhea and other symptoms, the plasma 5-HT levels were significantly higher than those patients without the above symptoms, and 5- The concentration of HT was positively correlated with the severity of symptoms (r = 0.714, P <0.001). Conclusions The exacerbation of symptoms of female diarrhea IBS after cold diet may be related to the increase of plasma 5-HT level.