功能性消化不良患者血清Ghrelin和瘦素水平以及心理因素的研究
发布时间：2019-01-23 22:02
【摘要】： 目的: 功能性消化不良(Functional dyspepsia,FD)是一组非常常见的临床症候群,患病率可达到11%～29.2%,患者生活质量有显著的下降,并造成了医疗资源的浪费。FD的发病机制尚未完全阐明,目前认为FD的发病与上胃肠道运动功能障碍、内脏高敏感性、胃酸分泌过高、幽门螺杆菌感染、心理、社会、饮食等诸多因素及多种因素的综合作用有关。Ghrelin是一种含有28个氨基酸的生长激素释放肽,瘦素(Leptin)是由肥胖基因(obese gene)编码,脂肪细胞分泌的一种激素,作为新近发现的两种脑肠肽它们对胃肠道的作用正逐渐被人们所认识。精神心理因素对FD的发病起了重要的作用,尤其是焦虑和抑郁状况。本文通过研究FD患者的血清Ghrelin及瘦素水平,焦虑及抑郁状况,以期对这种疾病有进一步的认识,为进一步阐明其发病机制、寻找有效的治疗方法提供依据。 方法: 选取44例FD患者并分成两组:餐后不适综合征(Postprandial distresssyndrome,PDS)组26人,上腹痛综合征(Epigastric pain syndrome,EPS)组18人;及39例健康对照者,分别采用酶联免疫法和放射免疫法进行血清Ghrelin及瘦素水平检测;采用抑郁自评量表(Self-Rating Depression Scale,SDS)和焦虑自评量表(Self-Rating Anxiety Scale,SAS)进行焦虑及抑郁状况评价;所得结果分别采用成组t检验,ANOVA单因素方差分析,Spearman相关分析,行×列表资料的χ~2检验及交叉分类2×2表的关联性分析。 结果: 1.FD组血清Ghrelin水平较对照组明显减低(P＜0.01);其中PDS组血清Ghrelin水平较对照组明显减低(P＜0.01),并且较EPS组也明显减低(P＜0.05);而EPS组血清Ghrelin水平与对照组比较,差异无统计学意义(P＞0.05)。 2.FD组血清瘦素水平较对照组明显减低(P＜0.05);其中PDS组血清瘦素水平较对照组明显减(P＜0.01),并且较EPS组也明显减低(P＜0.05);而EPS组血清瘦素水平与对照组比较的差异无统计学意义(P＞0.05)。 3.PDS组血清瘦素水平改变与血清Ghrelin水平改变之间呈正相关关系,而EPS组血清瘦素水平改变与血清Ghrelin水平改变之间不存在相关性。 4.FD组瘦素/Ghrelin与对照组两组比较,差异无统计学意义(P＞0.05):PDS组、EPS组和对照组三组比较、三组间两两比较瘦素/Ghrelin的差异均无统计学意义(P＞0.05)。 5.FD组、PDS组、EPS组的SAS评分、SDS评分、焦虑人数比例、抑郁人数比例、合并焦虑与抑郁的人数比例均较对照组明显增高;而PDS组与EPS组之间上述各项比较均无统计学意义(P＞0.05);SAS评分改变与SDS评分改变之间呈正相关关系;FD与SAS评分和SDS评分均存在正相关性。 6.FD组、PDS组、EPS组的血清Ghrelin、瘦素与SAS评分、SDS评分之间均不存在相关性(P＞0.05)。 结论: 1.FD患者血清Ghrelin和瘦素水平均下降;PDS患者血清Ghrelin和瘦素水平均下降;PDS患者血清瘦素与Ghrelin之间存在正相关关系,提示血清Ghrelin和瘦素的变化对FD特别是PDS的发病起促进作用,导致患者早饱,餐后饱胀不适等症状。 2.EPS患者血清Ghrelin和瘦素水平无明显变化,提示血清Ghrelin和瘦素的变化可能与EPS的发病无明显关系。 3.FD患者的SAS、SDS评分均增高,其中PDS和EPS患者的SAS、SDS评分也均增高,提示焦虑和抑郁情绪可能对FD的发病起促进作用,对存在焦虑和抑郁情况的患者进行相应的治疗会有疗效。
[Abstract]:Purpose: Functional dyspepsia (FD) is a group of very common clinical symptoms, and the prevalence rate can reach 11% ~ 29. 2%. The quality of life of the patient is significantly reduced and the medical resources are caused. The pathogenesis of FD has not yet been fully set out, and it is considered that FD is a combination of many factors, such as high gastrointestinal motility, visceral hypersensitivity, hypersecretion of gastric acid, infection of Helicobacter pylori, psychology, society, diet and many factors. Related. Ghrelin is a growth hormone-releasing peptide containing 28 amino acids. Leptin is a hormone encoded by the obese gene and secreted by the fat cells. As a newly discovered two-brain-intestinal peptide, their role in the gastrointestinal tract is gradually being The mental and psychological factors play an important role in the onset of FD, especially anxiety and depression. The status of serum Ghrelin and leptin levels, anxiety and depression in FD patients is studied in this paper, with a view to further understanding the disease, and to provide an effective treatment method for the further elucidation of its pathogenesis. On the basis of. Methods: 44 patients with FD were selected and divided into two groups: 26 patients with post-meal discomfort syndrome (PDS), 18 patients with epigastric pain syndrome (EPS), and 39 healthy controls. Self-Rating Scale (SDS) and Self-Rating Scale (SAS) were used for the evaluation of anxiety and depression. The results obtained were group t test, ANOVA, ANOVA, and Sea, respectively. rman-related analysis, 1-2 inspection and cross-classification of the list data of the line 2-table Results: The serum Ghrelin level in the 1. FD group was significantly lower than that in the control group (P <0.01), and the serum Ghrelin level in the PDS group was significantly lower than that in the control group (P <0.01), and the EPS group was also significantly reduced (P <0.05); and the serum G of the EPS group was significantly lower (P <0.05). the difference between the level of hrein and the control group The level of serum leptin in the group was significantly lower than that in the control group (P <0.05), and the level of serum leptin in the PDS group was significantly lower than that of the control group (P <0.01), and the level of serum leptin in the PDS group was lower than that of the control group (P <0.01). The level of serum leptin in EPS group was lower than that of control group (P <0.05). There was no significant difference between the level of serum leptin and the level of Ghrelin in the group (P> 0.05). There was no correlation between the changes of the level of Gretin. 4. There was no significant difference between the two groups (P> 0.05): PDS group, EPS group and control group. There was no statistical significance (P> 0.05) in the difference of rein (P> 0.05). The SAS scores, SDS scores, the proportion of anxiety, the proportion of the number of depression, the proportion of the patients with the combination of anxiety and depression were higher than that of the control group, and the PDS group and E. There was no significant difference between the PS group (P> 0.05), the change of SAS score and the change of SDS score was positive. Correlation: There was positive correlation between FD and SAS scores and SDS scores. and SA There was no correlation between the S scores and the SDS scores (P> 0.05). Conclusion: 1. The serum Ghrelin and leptin levels in the 1. FD patients are both decreased; the serum Ghrelin and leptin levels in the PDS patients are both decreased; there is a positive correlation between the serum leptin and Ghrelin in the PDS patients, and the serum Gh is indicated The change of relain and leptin the effect of chemical treatment on the onset of FD, especially the PDS, leads to the early satiety of the patient and the discomfort of the satiety after the meal. 2. The serum Ghrelin and the leptin in the EPS patients There was no obvious change in the level of serum Ghrelin and leptin, suggesting that the changes of serum Ghrelin and leptin may not be related to the pathogenesis of EPS.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R57;R395
本文编号：2414233
[Abstract]:Purpose: Functional dyspepsia (FD) is a group of very common clinical symptoms, and the prevalence rate can reach 11% ~ 29. 2%. The quality of life of the patient is significantly reduced and the medical resources are caused. The pathogenesis of FD has not yet been fully set out, and it is considered that FD is a combination of many factors, such as high gastrointestinal motility, visceral hypersensitivity, hypersecretion of gastric acid, infection of Helicobacter pylori, psychology, society, diet and many factors. Related. Ghrelin is a growth hormone-releasing peptide containing 28 amino acids. Leptin is a hormone encoded by the obese gene and secreted by the fat cells. As a newly discovered two-brain-intestinal peptide, their role in the gastrointestinal tract is gradually being The mental and psychological factors play an important role in the onset of FD, especially anxiety and depression. The status of serum Ghrelin and leptin levels, anxiety and depression in FD patients is studied in this paper, with a view to further understanding the disease, and to provide an effective treatment method for the further elucidation of its pathogenesis. On the basis of. Methods: 44 patients with FD were selected and divided into two groups: 26 patients with post-meal discomfort syndrome (PDS), 18 patients with epigastric pain syndrome (EPS), and 39 healthy controls. Self-Rating Scale (SDS) and Self-Rating Scale (SAS) were used for the evaluation of anxiety and depression. The results obtained were group t test, ANOVA, ANOVA, and Sea, respectively. rman-related analysis, 1-2 inspection and cross-classification of the list data of the line 2-table Results: The serum Ghrelin level in the 1. FD group was significantly lower than that in the control group (P <0.01), and the serum Ghrelin level in the PDS group was significantly lower than that in the control group (P <0.01), and the EPS group was also significantly reduced (P <0.05); and the serum G of the EPS group was significantly lower (P <0.05). the difference between the level of hrein and the control group The level of serum leptin in the group was significantly lower than that in the control group (P <0.05), and the level of serum leptin in the PDS group was significantly lower than that of the control group (P <0.01), and the level of serum leptin in the PDS group was lower than that of the control group (P <0.01). The level of serum leptin in EPS group was lower than that of control group (P <0.05). There was no significant difference between the level of serum leptin and the level of Ghrelin in the group (P> 0.05). There was no correlation between the changes of the level of Gretin. 4. There was no significant difference between the two groups (P> 0.05): PDS group, EPS group and control group. There was no statistical significance (P> 0.05) in the difference of rein (P> 0.05). The SAS scores, SDS scores, the proportion of anxiety, the proportion of the number of depression, the proportion of the patients with the combination of anxiety and depression were higher than that of the control group, and the PDS group and E. There was no significant difference between the PS group (P> 0.05), the change of SAS score and the change of SDS score was positive. Correlation: There was positive correlation between FD and SAS scores and SDS scores. and SA There was no correlation between the S scores and the SDS scores (P> 0.05). Conclusion: 1. The serum Ghrelin and leptin levels in the 1. FD patients are both decreased; the serum Ghrelin and leptin levels in the PDS patients are both decreased; there is a positive correlation between the serum leptin and Ghrelin in the PDS patients, and the serum Gh is indicated The change of relain and leptin the effect of chemical treatment on the onset of FD, especially the PDS, leads to the early satiety of the patient and the discomfort of the satiety after the meal. 2. The serum Ghrelin and the leptin in the EPS patients There was no obvious change in the level of serum Ghrelin and leptin, suggesting that the changes of serum Ghrelin and leptin may not be related to the pathogenesis of EPS.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R57;R395
【引证文献】
相关期刊论文 前3条
1 蔡顺天;王巍峰;杨云生;;ghrelin与功能性消化不良[J];胃肠病学和肝病学杂志;2011年06期
2 陈苏宁;礼海;史业东;;胃痛消痞方对功能性消化不良大鼠血清及胃组织中Ghrelin、Leptin的影响[J];世界华人消化杂志;2010年26期
3 张维;张t ;;胃促生长素与功能性消化不良的研究进展[J];中国现代医药杂志;2011年07期
相关硕士学位论文 前2条
1 张绍杰;加味枳实消痞汤对功能性消化不良胃肠激素的影响[D];广州中医药大学;2013年
2 王春燕;清化和胃片治疗餐后不适综合征的临床疗效评价研究[D];中国中医科学院;2013年
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