抑郁症胃动力障碍及钠尿肽信号通路的变化研究

发布时间：2018-05-31 06:10

本文选题：功能性胃肠病 + C型钠尿肽　；参考：《大连医科大学》2013年硕士论文

【摘要】：第一部分非器质性胃动力障碍患者抑郁量表分析目的：胃动力学及其相关疾病的研究已成为胃疾病至关重要的一部分，随着抑郁症患者的日益增多，由此引起的胃功能障碍性疾病也逐渐增多。本部分通过胃镜及其他相关检查得到20例功能性消化不良（functional dyspepsia，FD)患者，进一步行全胃肠钡餐透视、胃电检测及抑郁自评量表评分，，对FD患者胃动力及其合并抑郁症情况进行分析，并及时给予合理治疗。方法：入组2012年3月至2013年4月于大连医科大学附属第一医院消化科门诊及住院患者为研究对象。通过全胃肠钡餐透视、胃电检测及抑郁自评量表测定20例FD和20例正常组患者胃动力水平及FD合并抑郁症情况。结果：全胃肠钡餐透视下FD组胃张力、胃蠕动较正常组减弱，胃排空时间FD组较正常组延长(5.59±0.58h vs1.69±0.08h，P0.05)；胃电图FD组较正常组有差异(P0.05)；对已确诊的20例FD患者通过抑郁自评量表评分并分析，抑郁症患病率为30%。结论：功能性消化不良患者胃动力降低；30%功能性消化不良患者合并有抑郁症。第二部分抑郁引起胃运动障碍大鼠钠尿肽信号通路的变化及逍遥散的干预作用目的：本部分实验在之前临床实验的前提下，采用免疫组化、RT-qPCR及Western-blot技术，探讨抑郁引起胃运动障碍大鼠钠尿肽信号通路的变化及逍遥散的干预作用。方法：雄性SD大鼠75只，由大连医科大学实验动物中心提供，通过开野实验选取50只，适应性喂养1wk后随机分为A-E5组（依次是正常组、抑郁组、逍遥散低、中、高浓度组），实验持续3wk。A组正常饲养；B-E4组采取采用经典慢性综合应激模式，每天给予一种应激刺激（24h禁水，夹尾，束缚），每种重复2~3次；C-E3组分别于刺激前1小时低、中、高浓度逍遥散灌胃，同时A、B组生理盐水灌胃.3wk结束时处死动物，留取胃窦标本，行免疫组化、RT-qPCR、Western-blot技术测定大鼠C型钠尿肽（C-type natriuretic peptide，CNP）及其受体B型钠尿肽受体（B-type natriuretic peptide receptor，NPR-B）的表达情况。结果：抑郁大鼠胃窦环形肌自发性收缩对CNP抑制反应敏感性明显增加而逍遥散对其有改善作用；抑郁组大鼠CNP及NPR-B表达显著高于正常组（均P0.01）；逍遥散高浓度组较正常组差异无统计学意义，逍遥散中、高浓度组较抑郁组差异显著（均P0.01）；逍遥散低浓度组较正常组及抑郁组差异显著（均P0.01）。结论：钠尿肽信号通路上调是抑郁引起胃运动障碍的原因之一，逍遥散通过下调NP信号通路改善抑郁引起胃运动障碍。
[Abstract]:Part I analysis of depression scale in patients with non-organic gastric motility disorder Objective: the study of gastric dynamics and related diseases has become a vital part of gastric diseases. With the increasing number of depression patients, the resulting gastric dysfunction disease is also increasing. In this part, 20 patients with functional dyspepsia (FDD) were obtained by gastroscopy and other related examinations. The patients with FD were further examined with total gastrointestinal barium meal fluoroscopy, electrogastrogram examination and self-rating depression scale (SDS). The gastric motility and its associated depression in FD patients were analyzed. And give reasonable treatment in time. Methods: from March 2012 to April 2013, inpatients and outpatients from Department of Digestive Medicine, the first affiliated Hospital of Dalian Medical University were selected as subjects. Gastric motility and depression in 20 patients with FD and 20 normal controls were measured by total gastrointestinal barium meal fluoroscopy, gastric electrical examination and self rating depression scale. Results: gastric tension and gastric peristalsis in FD group were lower than those in normal group under total gastrointestinal barium meal fluoroscopy. The gastric emptying time in FD group was 5.59 卤0.58h vs1.69 卤0.08hP0.05U longer than that in the normal group, and there was a difference between the FD group and the normal group (P0.05A). The prevalence of depression was 30% in 20 patients with FD who had been diagnosed by self-rating depression scale (SDS). Conclusion: gastric motility in patients with functional dyspepsia is 30% with depression. The second part: the changes of natriuretic peptide signaling pathway in rats with gastric motility disorder induced by depression and the intervention effect of Xiaoyao San Objective: to investigate the changes of natriuretic peptide signaling pathway in rats with gastric motility disorder induced by depression and the intervention effect of Xiaoyao Powder by using immunohistochemical RT-qPCR and Western-blot techniques under the premise of previous clinical trials. Methods: 75 male Sprague-Dawley rats, provided by Experimental Animal Center of Dalian Medical University, were randomly divided into A-E5 group (normal group, depression group, Xiaoyao powder low, middle group) after feeding 1wk adaptively. In the high concentration group, the 3wk.A group was fed with the classical chronic comprehensive stress model. The rats were given a stress stimulation for 24 hours to ban water, clip the tail, and restrain the rats. The C-E3 group was low and moderate at 1 hour before the stimulation. Rats in group A were sacrificed at the end of oral administration of normal saline for 3 wk, and antral specimens were collected. The expression of C-type natriuretic peptide and B type natriuretic peptide receptor (B-type natriuretic peptide receptor, NPR-BB) was determined by immunohistochemistry with RT-qPCRX Western-blot. Results: the sensitivity of spontaneous contraction of antral annular muscle to CNP in depressed rats was significantly increased, while Xiaoyao San could improve it. The expression of CNP and NPR-B in the depression group was significantly higher than that in the normal group (P0.01), but there was no significant difference between the high concentration group of Xiaoyao Powder and the normal group. There was significant difference between the high concentration group and the depression group (all P 0.01), and the low concentration group of Xiaoyao San was significantly higher than that of the normal group and the depression group (all P 0.01). Conclusion: upregulation of natriuretic peptide signaling pathway is one of the causes of gastric motility disorder caused by depression. Xiaoyao Powder can improve gastric motility disorder caused by depression by down-regulating NP signal pathway.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.4;R573

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