便秘型肠易激综合征患者血清神经肽Y、P物质和5-羟色胺水平与焦虑抑郁的相关性
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摘要
为探讨便秘型肠易激综合征(constipation-predominant irritable bowel syndrome, C-IBS)患者血清神经肽Y (neuropeptide Y, NPY)、P物质(substance P, SP)以及5-羟色胺(5-hydroxytryptamine, 5-HT)水平与焦虑抑郁的相关性,本研究选取确诊为C-IBS的患者35例,健康对照组35例,采用焦虑自评表(self-rating anxiety scale, SAS)和抑郁自评表(self-rating depression scale, SDS)评定C-IBS患者和健康对照组的焦虑和抑郁状况。酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)检测C-IBS患者和健康对照组血清NPY、SP以及5-羟色胺含量变化。结果表明,IBS-C中出现抑郁、焦虑或者无抑郁、焦虑的患者在各方面(性别,年龄以及病程)无统计学意义。与健康对照组相比,C-IBS组NPY和SP水平显著降低(t=7.96, p<0.01; t=5.63, p<0.01),5-HT则表现出显著性升高(t=8.06, p<0.001)。C-IBS组SAS和SDS评分结果与健康对照组相比有着显著性的升高(t=12.13, p<0.001; t=11.34, p<0.001)。C-IBS患者血清NPY与SAS和SDS评分均呈负相关(r=-0.62, p<0.001; r=-0.69, p<0.001)。C-IBS患者血清SP水平与SAS和SDS评分均呈负相关(r=-0.63, p<0.001; r=-0.57, p<0.001)。C-IBS患者血清5-HT与SAS和SDS评分均呈正相关(r=0.74, p<0.001; r=0.68, p<0.001)。本研究初步表明,C-IBS患者血清中NPY和SP水平降低,并与焦虑、抑郁评分呈负相关性,5-HT在C-IBS患者血清中升高,与焦虑、抑郁评分呈正相关性,NPY、SP以及5-HT可能在便秘型肠易激综合征出现焦虑、抑郁的过程中发挥重要作用。
In order to investigate the correlation between levels of serum neuropeptide Y(NPY), substance P(SP),5-hydroxytryptamine(5-HT) and depression and anxiety in patients with constipation-predominant irritable bowel syndrome(C-IBS), 35 patients diagnosed as C-IBS and 35 healthy controls were selected in this research. Self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were used to evaluate the anxiety and depression circumstance of C-IBS patients and controls. The content of serum NPY, SP and 5-HT in C-IBS patients and healthy controls were detected by enzyme-linked immunosorbent assay(ELISA). The results showed that there was no statistical significance of gender, age, and duration between C-IBS patients with depression, anxiety and C-IBS patients without depression, anxiety. Compared with the healthy control group, the levels of NPY and SP in the C-IBS group were significantly decreased(t=7.96, p<0.01; t=5.63, p<0.01), and serotonin(5-HT) was significantly increased(t=8.06, p<0.001). The scores of SAS and SDS in C-IBS group were significantly higher than those in healthy control group(t =12.13, p <0.001; t =11.34, p <0.001). The serum level of NPY in C-IBS patients was negatively correlated with SAS and SDS scores(r=-0.62, p<0.001; r=-0.69, p<0.001). The serum level of SP in C-IBS patients was negatively correlated with SAS and SDS scores(r =-0.63, p <0.001; r =-0.57, p <0.001). The serum 5-HT level in C-IBS patients was positively correlated with SAS and SDS scores(r=0.74, p<0.001; r=0.68,p<0.001). This study initially showed that the serum levels of NPY and SP in C-IBS patients were decreased and negatively correlated with anxiety and depression scores. The serum level of 5-HT in C-IBS patients was increased and positively correlated with anxiety and depression scores. NPY, SP and 5-HT might play an important role in the pathologic process of C-IBS with anxiety and depression.
In order to investigate the correlation between levels of serum neuropeptide Y(NPY), substance P(SP),5-hydroxytryptamine(5-HT) and depression and anxiety in patients with constipation-predominant irritable bowel syndrome(C-IBS), 35 patients diagnosed as C-IBS and 35 healthy controls were selected in this research. Self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were used to evaluate the anxiety and depression circumstance of C-IBS patients and controls. The content of serum NPY, SP and 5-HT in C-IBS patients and healthy controls were detected by enzyme-linked immunosorbent assay(ELISA). The results showed that there was no statistical significance of gender, age, and duration between C-IBS patients with depression, anxiety and C-IBS patients without depression, anxiety. Compared with the healthy control group, the levels of NPY and SP in the C-IBS group were significantly decreased(t=7.96, p<0.01; t=5.63, p<0.01), and serotonin(5-HT) was significantly increased(t=8.06, p<0.001). The scores of SAS and SDS in C-IBS group were significantly higher than those in healthy control group(t =12.13, p <0.001; t =11.34, p <0.001). The serum level of NPY in C-IBS patients was negatively correlated with SAS and SDS scores(r=-0.62, p<0.001; r=-0.69, p<0.001). The serum level of SP in C-IBS patients was negatively correlated with SAS and SDS scores(r =-0.63, p <0.001; r =-0.57, p <0.001). The serum 5-HT level in C-IBS patients was positively correlated with SAS and SDS scores(r=0.74, p<0.001; r=0.68,p<0.001). This study initially showed that the serum levels of NPY and SP in C-IBS patients were decreased and negatively correlated with anxiety and depression scores. The serum level of 5-HT in C-IBS patients was increased and positively correlated with anxiety and depression scores. NPY, SP and 5-HT might play an important role in the pathologic process of C-IBS with anxiety and depression.
引文
Chen L.,Quan J.,Zhang X.D.,Zhu H.H.,Chen L.L.,Yan J.,Zhang L.,Shen J.,and Kong G.M.,2015,Correlation between functional dyspepsia-overlapped irritable bowel syndrome and gastrointestinal hormones in the elderly,Zhonghua Laonian Yixue Zazhi(Chinese Journal of Geriatrics),34(4):394-396(陈磊,全俊,张旭东,朱海杭,陈莉丽,严晋,张蕾,沈健,孔桂美,2015,老年人肠易激综合征并功能性消化不良与胃肠激素相关性研究,中华老年医学杂志,34(4):394-396)
Chen M.X.,Chen Y.,Fu R.,Liu S.Y.,Yang Q.Q.,and Shen T.B.,2016,Activation of 5-HT and NR2B contributes to visceral hypersensitivity in irritable bowel syndrome in rats,Am.J.Transl.Res.,8(12):5580-5590
Chey W.D.,Lembo A.,Phillips J.A.,and Rosenbaum D.P.,2015,1020 Efficacy and safety of tenapanor in patients with constipation predominant irritable bowel syndrome:A 12-week,double-blind,placebo-controlled,randomized phase 2B trial,Gastroenterology,148(4):S191-S192
Elisei C.,and de Castro A.P.,2017,Insight into role of microbiota-gut-brain peptides as a target for biotechnology innovations,Front.Biosci.(Elite Ed.),(9):76-88
Harris L.A.,Umar S.B.,Baffy N.,and Heitkemper M.M.,2016,Irritable bowel syndrome and female patients,Gastroenterol.Clin.North Am.,45(2):179-204
Koloski N.A.,Jones M.,Young M.,and Talley N.J.,2015,Differentiation of functional constipation and constipation predominant irritable bowel syndrome based on Rome III criteria:a population-based study,Aliment.Pharmacol.Ther.,41(9):856-866
Lu P.,Luo H.S.,Quan X.J.,Yu G.,Tang Q.C.,Fan H.,and Chen W.,2016,The potential effects of chronic stress on the expression of substance P and its related receptors in rat colon,Zhonghua Shiyan Waike Zazhi(Chinese Journal of Experimental Surgery),33(8):1996-1999(卢平,罗和生,全晓静,余光,唐勤彩,樊菡,陈炜,2016,慢性应激大鼠模型肠道P物质及其受体表达的变化,中华实验外科杂志,33(8):1996-1999)
Mearin F.,Ciriza C.,Mínguez M.,Rey E.,Mascort J.J.,Pea E.,Caones P.,and Júdez J.,2016,Clinical practice guideline:Irritable bowel syndrome with constipation and functional constipation in the adult,Revista Espanola De Enfermedades Digestivas Organo Oficial De La Sociedad Espanola De Patologia Digestiva,108(6):332-363
Perrenoud Q.,Rossier J.,Férézou I.,Geoffroy H.,Gallopin T.,Vitalis T.,and Rancillac A.,2012,Activation of cortical5-HT3receptor-expressing interneurons induces NO mediated vasodilatations and NPY mediated vasoconstrictions,Front.Neural Circuits,6:50
Quigley E.M.,2015,Editorial:differentiating chronic idiopathic constipation from constipation-predomina nt irritable bowel syndrome-possible and important?Aliment.Pharmacol.Ther.,41(12):1299
TachéY.,2015,Modulation of the autonomic nervous system by peptides:Implication in brain-gut axis,Autonomic Neuroscience,(192):29-30
Talley N.J.,Koloski N.A.,and Jones M.P.,2015,Editorial:differentiating chronic idiopathic constipation from constipation-predominant irritable bowel syndrome--possible and important?-Authors'reply,Aliment.Pharmacol.Ther.,41(12):1300
Thomas R.H.,and Luthin D.R.,2015,Current and emerging treatments for irritable bowel syndrome with constipation and chronic idiopathic constipation:focus on prosecretory a gents,Pharmacotherapy,35(6):613-630
Zhang Y.N.,Zhao H.J.,Wang Y.,Lu Y.,and Wang S.J.,2016,Effect of electroacupuncture intervention on constipation-predominant irritable bowel syndrome and colonic CGRP and SP expression in rats,Zhenci Yanjiu(Acupuncture Research),41(1):31-34(张亚楠,赵海军,王媛,卢岩,王世军,2016,降钙素基因相关肽、P物质在电针缓解便秘型肠易激综合征中的作用,针刺研究,41(1):31-34)
Zhao Y.Z.,Jin R.R.,Yang W.,Xiang Q.,Yu W.Z.,Lin Q.,Tian F.R.,Mao K.L.,Lv C.Z.,Wang Y.X.,and Lu C.T.,2016,Using gelatin nanoparticle mediated intranasal delivery of neuropeptide substance P to enhance neuro-recovery in hemiparkinsonian rats,PLoS One,11(2):e0148848
Chen M.X.,Chen Y.,Fu R.,Liu S.Y.,Yang Q.Q.,and Shen T.B.,2016,Activation of 5-HT and NR2B contributes to visceral hypersensitivity in irritable bowel syndrome in rats,Am.J.Transl.Res.,8(12):5580-5590
Chey W.D.,Lembo A.,Phillips J.A.,and Rosenbaum D.P.,2015,1020 Efficacy and safety of tenapanor in patients with constipation predominant irritable bowel syndrome:A 12-week,double-blind,placebo-controlled,randomized phase 2B trial,Gastroenterology,148(4):S191-S192
Elisei C.,and de Castro A.P.,2017,Insight into role of microbiota-gut-brain peptides as a target for biotechnology innovations,Front.Biosci.(Elite Ed.),(9):76-88
Harris L.A.,Umar S.B.,Baffy N.,and Heitkemper M.M.,2016,Irritable bowel syndrome and female patients,Gastroenterol.Clin.North Am.,45(2):179-204
Koloski N.A.,Jones M.,Young M.,and Talley N.J.,2015,Differentiation of functional constipation and constipation predominant irritable bowel syndrome based on Rome III criteria:a population-based study,Aliment.Pharmacol.Ther.,41(9):856-866
Lu P.,Luo H.S.,Quan X.J.,Yu G.,Tang Q.C.,Fan H.,and Chen W.,2016,The potential effects of chronic stress on the expression of substance P and its related receptors in rat colon,Zhonghua Shiyan Waike Zazhi(Chinese Journal of Experimental Surgery),33(8):1996-1999(卢平,罗和生,全晓静,余光,唐勤彩,樊菡,陈炜,2016,慢性应激大鼠模型肠道P物质及其受体表达的变化,中华实验外科杂志,33(8):1996-1999)
Mearin F.,Ciriza C.,Mínguez M.,Rey E.,Mascort J.J.,Pea E.,Caones P.,and Júdez J.,2016,Clinical practice guideline:Irritable bowel syndrome with constipation and functional constipation in the adult,Revista Espanola De Enfermedades Digestivas Organo Oficial De La Sociedad Espanola De Patologia Digestiva,108(6):332-363
Perrenoud Q.,Rossier J.,Férézou I.,Geoffroy H.,Gallopin T.,Vitalis T.,and Rancillac A.,2012,Activation of cortical5-HT3receptor-expressing interneurons induces NO mediated vasodilatations and NPY mediated vasoconstrictions,Front.Neural Circuits,6:50
Quigley E.M.,2015,Editorial:differentiating chronic idiopathic constipation from constipation-predomina nt irritable bowel syndrome-possible and important?Aliment.Pharmacol.Ther.,41(12):1299
TachéY.,2015,Modulation of the autonomic nervous system by peptides:Implication in brain-gut axis,Autonomic Neuroscience,(192):29-30
Talley N.J.,Koloski N.A.,and Jones M.P.,2015,Editorial:differentiating chronic idiopathic constipation from constipation-predominant irritable bowel syndrome--possible and important?-Authors'reply,Aliment.Pharmacol.Ther.,41(12):1300
Thomas R.H.,and Luthin D.R.,2015,Current and emerging treatments for irritable bowel syndrome with constipation and chronic idiopathic constipation:focus on prosecretory a gents,Pharmacotherapy,35(6):613-630
Zhang Y.N.,Zhao H.J.,Wang Y.,Lu Y.,and Wang S.J.,2016,Effect of electroacupuncture intervention on constipation-predominant irritable bowel syndrome and colonic CGRP and SP expression in rats,Zhenci Yanjiu(Acupuncture Research),41(1):31-34(张亚楠,赵海军,王媛,卢岩,王世军,2016,降钙素基因相关肽、P物质在电针缓解便秘型肠易激综合征中的作用,针刺研究,41(1):31-34)
Zhao Y.Z.,Jin R.R.,Yang W.,Xiang Q.,Yu W.Z.,Lin Q.,Tian F.R.,Mao K.L.,Lv C.Z.,Wang Y.X.,and Lu C.T.,2016,Using gelatin nanoparticle mediated intranasal delivery of neuropeptide substance P to enhance neuro-recovery in hemiparkinsonian rats,PLoS One,11(2):e0148848