Mayo Clinic, Rochester, MN 55905, USA.
Neurogastroenterol Motil. 2012 Jun;24(6):531-9, e249. doi: 10.1111/j.1365-2982.2012.01894.x. Epub 2012 Feb 17.
Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis.
Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson's correlation coefficients.
Interstitial cells of Cajal counts inversely correlated with 4 h gastric retention in DG but not in IG (r = -0.6, P = 0.008, DG, r = 0.2, P = 0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r = 0.5, P = 0.03 for DG, r = 0.3, P = 0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6 ± 0.7 vs 2.7 ± 0.9, P = 0.05) and nausea score (3.8 ± 0.9 vs 2.6 ± 1.0, P = 0.02) as compared to those without an infiltrate.
CONCLUSIONS & INFERENCES: In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.
最近，从参加胃轻瘫临床研究联合会的患者中描述了与糖尿病（DG）和特发性胃轻瘫（IG）相关的细胞变化。这些细胞变化与胃轻瘫症状和胃排空的关系尚不清楚。本研究的目的是将细胞变化与胃轻瘫患者的症状和胃排空相关联。
此前，我们使用 20 例 DG、20 例 IG 和 20 例匹配对照的胃体全层活检，发现 DG 和 IG 中 ICC 和肠神经的间质细胞减少，免疫细胞增加。在这里，使用 Pearson 相关系数将人口统计学资料、症状[胃轻瘫关键症状指数评分（GCSI）]和胃排空与细胞改变相关联。
DG 中 ICC 计数与 4 小时胃潴留呈负相关，但 IG 中无相关性（r = -0.6，P = 0.008，DG，r = 0.2，P = 0.4，IG）。DG 中 ICC 和肠神经的丧失也存在显著相关性，但 IG 中无相关性（r = 0.5，P = 0.03，DG，r = 0.3，P = 0.16，IG）。具有肌间免疫浸润的特发性胃轻瘫的平均 GCSI（3.6 ± 0.7 对 2.7 ± 0.9，P = 0.05）和恶心评分（3.8 ± 0.9 对 2.6 ± 1.0，P = 0.02）均高于无浸润者。
在 DG 中，ICC 的丧失与胃排空延迟有关。ICC 或肠神经丧失与症状严重程度无关。IG 的整体临床严重程度和恶心与肌间免疫浸润有关。因此，全层胃活检可以帮助确定胃轻瘫的特定细胞异常，其中一些与胃轻瘫的生理和临床特征相关。
