Sarkar A M, Akhter S, Khan M R, Saha M, Alam M R, Ghosh C K, Ahmed D S, Miah A R, Roy P K
Dr Md Abdul Mumit Sarkar, Resident, Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Med J. 2019 Jan;28(1):150-156.
Several mechanisms have been proposed to explain the symptoms of functional dyspepsia but actual pathogenesis is still poorly understood. Recent studies support duodenal abnormality to be the most important causal link to explain symptoms and to understand abnormal pathophysiology of functional dyspepsia. The aim of this prospective observational study is to compare eosinophil count in duodenal mucosa between patients with functional dyspepsia and control subjects without dyspepsia and was done at the department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from December 2015 to December 2016. Total 42 patients of functional dyspepsia based on Bangla validated version of ROME III criteria and 42 controls who were referred for upper gastrointestinal endoscopy for reasons other than dyspepsia were included. Biopsy specimens were collected from the second part (D2) of the duodenum of all participants. Eosinophil count was quantitatively evaluated by hematoxylin and eosin staining and expressed in numbers per 5 HPF. Significantly increased duodenal eosinophil count was found in functional dyspepsia group than non dyspeptic patients (22.78±08.78 vs. 14.90±10.70, p=0.001). Higher duodenal eosinophil count was found in patients with postprandial distress syndrome. Increased duodenal eosinophil count was found in patient of functional dyspepsia. It requires further large scale multicenter studies to establish duodenal eosinophilia as a biomarker of functional dyspepsia.
已经提出了几种机制来解释功能性消化不良的症状，但实际发病机制仍知之甚少。最近的研究支持十二指肠异常是解释症状和理解功能性消化不良异常病理生理学的最重要因果联系。这项前瞻性观察性研究的目的是比较功能性消化不良患者和无消化不良的对照受试者十二指肠黏膜中的嗜酸性粒细胞计数，该研究于2015年12月至2016年12月在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学胃肠病学系进行。纳入了42例基于孟加拉语验证版ROME III标准的功能性消化不良患者和42例因消化不良以外的原因接受上消化道内镜检查的对照者。从所有参与者十二指肠的第二部分（D2）采集活检标本。通过苏木精和伊红染色对嗜酸性粒细胞计数进行定量评估，并以每5个高倍视野中的数量表示。功能性消化不良组的十二指肠嗜酸性粒细胞计数显著高于无消化不良患者（22.78±08.78对14.90±10.70，p = 0.001）。餐后不适综合征患者的十二指肠嗜酸性粒细胞计数更高。功能性消化不良患者的十二指肠嗜酸性粒细胞计数增加。需要进一步的大规模多中心研究来确定十二指肠嗜酸性粒细胞增多作为功能性消化不良的生物标志物。
