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功能性消化不良患者心理生理应激实验中胃动素和神经肽Y样免疫反应性

Motilin- and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia.

作者信息

Jonsson B H, Hellström P M

机构信息

Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.

出版信息

Integr Physiol Behav Sci. 2000 Oct-Dec;35(4):256-65. doi: 10.1007/BF02688788.

Abstract

BACKGROUND

The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment.

METHOD

25 patients (12 men, 13 women), age 24-50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects' self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms.

RESULTS

Mean plasma MOT-LI concentration was 7.3 (CI: 5.7-9.4) pmol/L in the patient group, and 7.9 (CI: 6.1-10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3-16.4) pmol/L in the patient group, and 13.4 (Cl: 11.8-15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05).

CONCLUSION

During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.

摘要

背景

本研究的目的是在一项对照心理生理实验中比较功能性消化不良(FD)患者的血浆胃动素样免疫反应性(MOT-LI)和神经肽Y(NPY)样免疫反应性(NPY-LI)。

方法

对25例年龄在24至50岁之间、患有复发性FD的患者(12名男性,13名女性)以及25名年龄和性别匹配的社区对照受试者进行了研究。在一项实验中,经过一段休息期后,受试者在15分钟的应激访谈期间接受研究。访谈的目的是引发焦虑。在干预前和干预期间采集血样进行肽分析。结果指标包括胃肠道症状评分量表、空腹血糖、心率和血压以及受试者在视觉模拟量表上的自我评分。MOT-LI和NPY-LI的血浆浓度以反对数表示。

结果

患者组的平均血浆MOT-LI浓度为7.3(CI:5.7 - 9.4)pmol/L,对照组为7.9(CI:6.1 - 10.2)pmol/L。患者组的平均血浆NPY-LI浓度为14.2(CI:12.3 - 16.4)pmol/L,对照组为13.4(CI:11.8 - 15.3)pmol/L。使用协方差分析(协变量:组、性别、年龄、体重指数和吸烟情况),MOT-LI与较低的消化不良症状(p<0.04)以及访谈期间愉悦感的正向变化(p<0.03)相关。在患者组中,胃动素变化量与愉悦感增加(p<0.03)和悲伤感降低(p<0.03)相关。访谈期间NPY-LI的增加与访谈前较高的空腹血糖(p<0.01)以及测试期间收缩压的更强升高(p<0.05)相关。

结论

在应激访谈期间,血浆MOT-LI与较少的消化不良症状和愉悦感呈正相关,而血浆NPY-LI的变化与交感神经系统活动呈正相关,但与胃肠道症状无关。

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