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目的观察肠易激综合征(IBS)患者结肠黏膜肠嗜铬细胞(EC 细胞)的分布特点及其合成和储存5-羟色胺(5-HT)的功能变化,探讨其在 IBS 发病中的作用。方法符合 RomeⅡ诊断标准的 IBS 患者51例,以其分型标准区分为腹泻型和便秘型。经肠镜活检 IBS 患者结肠黏膜标本行 S-P 法免疫组化染色。部分活检标本电镜下观察 EC 细胞功能状态。免疫组化染色及电镜观察均设正常对照组。结果 IBS 组与正常对照组比较:(1)光镜下 IBS 组 EC 细胞形态饱满,体积较大,提示 EC 细胞合成5-HT增加。电镜下可见 IBS 组 EC 细胞内分泌颗粒多。(2)IBS 组回盲部 EC 细胞数量与正常对照组无差异(P>0.05),IBS 患者组直肠-乙状结肠交界处 EC 细胞数量较正常对照组显著增加(P<0.05)。结论 IBS 病人结肠黏膜 EC 细胞数量增加与功能活跃,5-HT 分泌增高,提示5-HT 可能在 IBS 发病中起到重要作用。
Objective To investigate the distribution of colonic mucosal enterochromaffin cells (ECs) in patients with irritable bowel syndrome (IBS) and their function in the synthesis and storage of 5-hydroxytryptamine (5-HT), and to explore their roles in the pathogenesis of IBS. Methods Fifty-one patients with IBS who met Rome Ⅱ criteria were divided into diarrhea-type and constipation-type according to their typing criteria. Colon biopsy IBS colon mucosa specimens by immunohistochemical S-P staining. Some biopsy specimens were observed under electron microscope EC cell function status. Immunohistochemical staining and electron microscopy were normal control group. Results IBS group compared with the normal control group: (1) under light microscope IBS group EC cells full shape, larger volume, suggesting that EC cells increased 5-HT synthesis. Electron microscope shows IBS group EC cells endocrine granules more. (2) The number of EC cells in ileocecal part of IBS group was not significantly different from that in normal control group (P> 0.05). The number of EC cells in rectum - sigmoid junction of IBS group was significantly higher than that in normal control group (P <0.05). Conclusions The number of EC cells in colonic mucosa of IBS patients is increased and the function is active, and the secretion of 5-HT is increased, suggesting that 5-HT may play an important role in the pathogenesis of IBS.