Zhang Hongjie, Yan Yan, Shi Ruihua, Lin Zheng, Wang Meifeng, Lin Lin
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Digestion. 2008;78(2-3):72-6. doi: 10.1159/000165352. Epub 2008 Oct 24.
Irritable bowel syndrome (IBS) is a functional bowel disorder which is characterized by abdominal pain and disturbed bowel habits. The pathophysiological mechanism is complex and still remains incompletely clear. Alterations at both the central and the peripheral level are thought to contribute to the symptoms of IBS, including psychosocial factors, visceral hypersensitivity and abnormal gastrointestinal motility and secretion. Several gut peptides contribute to the regulation of gastrointestinal function, but little is known about gut hormone secretion in IBS.
We evaluated the concentrations of cholecystokinin (CCK), vasoactive intestinal peptide (VIP), somatostatin, substance P, neuropeptide Y (NPY) in plasma and in sigmoid tissue in 40 patients with IBS and 15 age- and gender-matched controls by using radioimmunoassay.
IBS patients had higher plasma level of CCK (p < 0.01), and the level of CCK in the sigmoid was also increased compared with controls (p < 0.05). The levels of somatostatin and substance P in fasting plasma and in the sigmoid were not different between IBS patients and control subjects (p > 0.05), but the levels of VIP in sigmoid tissue or in plasma were higher in IBS patients than in control group (p < 0.01). The NPY levels in both plasma and the sigmoid were significantly lower in IBS patients than in controls (p < 0.05). Plasma NPY level in patients with IBS with diarrhea as a predominant bowel pattern was lower than in patients with IBS with constipation as a predominant bowel pattern.
IBS patients have increased levels of CCK and VIP and decreased NPY levels in fasting plasma and sigmoid tissue. These alterations of VIP, CCK and NPY may play a role in the pathogenesis of IBS.
肠易激综合征（IBS）是一种功能性肠道疾病，其特征为腹痛和排便习惯紊乱。其病理生理机制复杂，仍不完全清楚。中枢和外周水平的改变均被认为与IBS的症状有关，包括心理社会因素、内脏高敏感性以及胃肠动力和分泌异常。几种胃肠肽参与胃肠功能的调节，但关于IBS患者胃肠激素分泌的情况知之甚少。
我们采用放射免疫分析法评估了40例IBS患者及15例年龄和性别匹配的对照者血浆和乙状结肠组织中胆囊收缩素（CCK）、血管活性肠肽（VIP）、生长抑素、P物质、神经肽Y（NPY）的浓度。
IBS患者血浆CCK水平较高（p < 0.01），与对照组相比，乙状结肠中CCK水平也升高（p < 0.05）。IBS患者与对照者之间空腹血浆和乙状结肠中生长抑素和P物质水平无差异（p > 0.05），但IBS患者乙状结肠组织或血浆中VIP水平高于对照组（p < 0.01）。IBS患者血浆和乙状结肠中的NPY水平均显著低于对照组（p < 0.05）。以腹泻为主型的IBS患者血浆NPY水平低于以便秘为主型的IBS患者。
IBS患者空腹血浆和乙状结肠组织中CCK和VIP水平升高，NPY水平降低。VIP、CCK和NPY的这些改变可能在IBS的发病机制中起作用。
