肠易激综合征治疗前后氢呼气试验参数及胃肠激素分泌水平的变化研究

摘要

目的 探究肠易激综合征(IBS)患者治疗前后氢呼气试验参数及胃肠激素分泌水平的变化情况.方法 采用氢呼气试验测定正常对照组及IBS患者口盲传输时间(OTCC)及产生H2浓度,同时利用放射免疫法检测正常对照组及IBS患者血浆中胃动素(MTL)、血管活性肠肽(VIP)、胆囊收缩素(CCK)和生长抑素(SS)的含量.结果 治疗前腹泻组患者OCTT显著低于对照组和便秘组,且便秘组OCTT显著高于对照组(P＜0.05),治疗前IBS患者H2浓度和SIBO阳性率均显著高于对照组(P＜0.05),治疗后H2浓度和SIBO阳性率显著降低,差异有统计学意义(P＜ 0.05).治疗前腹泻组患者血浆中MTL和CCK明显高于对照组和便秘组,治疗后腹泻组患者MTL和CCK水平较治疗前显著降低,而便秘组较治疗前显著升高(P＜0.05);而治疗前IBS患者血浆中VIP和SS明显高于对照组,治疗后IBS患者VIP和SS水平较治疗前显著降低,差异有统计学意义(P＜0.05).结论 氢呼气试验参数和胃肠激素分泌水平改变与IBS发病过程密切相关.%Objective To explore the changes of the parameters of hydrogen breath test and secretion levels of gastrointestinal hormones in patients with irritable bowel syndrome (IBS) before and after treatment.Methods The hydrogen breath test was performed to determine oro-cecal transit time (OTCC) and the concentration of produced H2 in the normal control group and patients with IBS.Meanwhile,radioimmunoassay was used to detect the contents of plasma motilin (MTL),vasoactive intestinal peptide (VIP),cholecystokinin (CCK),and somatostatin (SS) in normal control group and patients with IBS.Results Before treatment,OCTT in patients with diarrhea was significantly lower than those in the normal group and patients with constipation,OCTT in patients with constipation was significantly higher than that in the normal group (P＜0.05).Before treatment,the concentration of H2 and the positive rate of SIBO in patients with IBS were significantly higher than those in the normal group,the concentration ofH2 and the positive rate of SIBO significantly decreased after treatment (P＜0.05).Before treatment,the concentrations of plasma MTL and CCK in patients with diarrhea were significantly higher than those in normal group and patients with constipation,the concentrations of plasma MTL and CCK in patients with diarrhea significantly decreased after treatment,while those in patients with constipation significantly increased (P＜0.05).Before treatment,the concentrations of VIP and SS in patients with IBS were significantly higher than those in normal group,the concentrations of VIP and SS in patients with IBS significantly decreased after treatment (P＜0.05).Conclusion The changes of the parameters of hydrogen breath test and secretion of gastrointestinal hormones are closely related to the pathogenesis of IBS.