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肠易激综合征重叠功能性消化不良患者情绪障碍及其与脑肠肽、细胞因子水平关系

Mood disorder in patients with irritable bowel syndrome overlapped with functional dyspepsia and its relationship with ghrelin and cytokine levels

摘要:

目的:探讨肠易激综合征(IBS)重叠功能性消化不良(FD)患者情绪障碍及其与脑肠肽、细胞因子水平关系。方法选取2010年6月至2013年6月本院消化科收治的64例IBS重叠FD患者作为研究对象,采用焦虑调查表(SAS)、抑郁调查表(SDS)调查患者负面情绪,比较患者的内皮素、生长抑素(SS)、5?羟色胺以及血管活性肠肽(VIP)等水平。结果病例组患者SAS、SDS评分均高于对照组,差异有统计学意义(P<0.05);单因素分析结果显示,情绪障碍组和无情绪障碍组患者在病程、婚姻方面及IL?10、VIP、SS、5?羟色胺水平与对照组比较差异均有统计学意义(P<0.05);且VIP水平显著低于无情绪障碍组患者;病程<1年患者IL?10、5?羟色胺水平均高于1~5年、>5年患者(P<0.05);>5年患者内皮素、VIP水平均高于<1年、1~5年患者(P<0.05)。结论 IBS重叠FD患者焦虑、抑郁水平处于轻度范畴,可能与病程和婚姻状态有关,患者消化道症状可能与内皮素、SS、VIP水平有密切关系。

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Objective To investigate the mood disorder in patients with irritable bowel syndrome (IBS)overlapped with functional dyspepsia(FD)and its relationship with ghrelin and cytokine levels in the patients. Methods The study subjects were 64 patients with FD?overlapped IBS treated in our Department of Gastroenterology between June 2010 and June 2013. Self?Rating Anxiety Scale(SAS)and Self?Rating Depression Scale (SDS) were used to measure the negative emotions in these patients. The levels of endothelin,somatostatin (SS),5?serotonin and vasoactive intestinal peptide (VIP) in the patients were investigated and compared. Results Compared with the control group,patients with FD?overlapped IBS had higher scores by SAS and SDS,with statistically significant difference (P<0.05). Univariate analysis indicated that,compared with controls,patients with or without mood disorders showed statistical differences in duration of disease,marital status,and levels of IL?10,VIP,SS and 5?serotonin(P<0.05);VIP level was significantly lower in patients with than those without mood disorder. Patients with <1 year duration of disease had higher IL?10 and 5?serotonin levels compared to those with disease duration between 1 and 5 years,and much higher IL?10 and 5?serotonin levels compared to those with>5 years duration of disease(P<0.05). Patients with>5 years duration of disease had higher endothelin and VIP levels compared to those with duration of disease<1 year or between 1 and 5 years(P<0.05). Conclusion FD?overlapped IBS patients have mild range of anxiety and depression which may be related to the disease duration and marital status. The gastrointestinal symptoms in these patients may be closely associated with endothelin,SS and VIP levels.

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