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急性胃肠道感染相关性功能性消化不良的初步研究

[A preliminary study of acute gastrointestinal infection-associated functional dyspepsia].

作者信息

Li Wei-Guang, Li Xiao-Bo, Ge Zhi-Zheng

机构信息

Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Disgestive Disease, Shanghai 200001, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2008 Sep;47(9):739-42.

Abstract

OBJECTIVE

To investigate the clinical characters and the possible pathogenesis of post-infectious functional dyspepsia (PI-FD).

METHODS

550 patients suffered with acute gastrointestinal infection were followed-up for half year to evaluate the prevalence and symptoms of PI-FD. Meanwhile, thirty patients with non-special functional despepsra (NS-FD) and twenty healthy volunteers were enrolled. The number of mast cells, the total amount of tryptase and histamine released were determined. Furthermore, the ultra-structure of mast cells was observed by electron microscope, and the number of mast cells located within 5 microm of nerve fibers was also countered.

RESULTS

The prevalence of PI-FD is about 6.7% (35/522) after acute gastrointestinal infection in half year. The scores of epigastric pain, epigastric burning sensation and early satiety in patients with PI-FD were significantly higher than those in patients with NS-FD (P < 0.05 for all), so did the scores of histological chronic inflammation in gastric mucosa (P < 0.05). There is no significant difference in the number of mast cells between patients with PI-FD and NS-FD (P > 0.05). However, the number of activated mast cells in patients with PI-FD is significantly higher than that in patients with NS-FD. The total amount of tryptase in gastric mucosa and the histamine released in patients with PI-FD is higher than that in patients with NS-FD and healthy volunteers (P < 0.05 for all). Under the electron microscope, the number of mast cells located within 5 microm of nerve fibers in PI-FD patients was significant higher than that in other two groups (P < 0.05 for all).

CONCLUSIONS

PI-FD is probably a specific type of functional dyspepsia. Epigastric pain, epigastric burning sensation, and early satiety are the major symptoms in these patients. Mast cells maybe involved in the pathogenesis of PI-FD.

摘要

目的

探讨感染后功能性消化不良(PI-FD)的临床特征及可能的发病机制。

方法

对550例急性胃肠道感染患者进行半年随访,以评估PI-FD的患病率及症状。同时,纳入30例非特异性功能性消化不良(NS-FD)患者和20名健康志愿者。测定肥大细胞数量、类胰蛋白酶释放总量及组胺释放量。此外,通过电子显微镜观察肥大细胞超微结构,并计数位于神经纤维5微米范围内的肥大细胞数量。

结果

急性胃肠道感染半年后PI-FD的患病率约为6.7%(35/522)。PI-FD患者的上腹部疼痛、上腹部烧灼感和早饱评分显著高于NS-FD患者(均P<0.05),胃黏膜组织学慢性炎症评分也更高(P<0.05)。PI-FD患者与NS-FD患者的肥大细胞数量无显著差异(P>0.05)。然而,PI-FD患者的活化肥大细胞数量显著高于NS-FD患者。PI-FD患者胃黏膜类胰蛋白酶释放总量及组胺释放量高于NS-FD患者和健康志愿者(均P<0.05)。在电子显微镜下,PI-FD患者位于神经纤维5微米范围内的肥大细胞数量显著高于其他两组(均P<0.05)。

结论

PI-FD可能是功能性消化不良的一种特殊类型。上腹部疼痛、上腹部烧灼感和早饱是这些患者的主要症状。肥大细胞可能参与PI-FD的发病机制。

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