肠易激综合征亚型患者具有肠道和躯体高敏感,自主心血管功能紊乱以及肠道低浓度炎症

研究目的：明确腹泻型肠易激综合征患者是否具有肠道和躯体高敏感、自主心血管功能紊乱以及肠道低浓度炎症。创新要点：发现腹泻型肠易激综合征患者具有自主心血管功能紊乱和肠道低浓度炎症（这两方面在之前研究中尚存争议）。此外,发现腹泻型肠易激综合征患者的肠道高敏感和躯体高敏感、肠道高敏感和自主心血管功能紊乱、躯体高敏感和自主心血管紊乱之间存在相关性,为患者的治疗提供参考。研究方法：2013年9月至2014年5月,62名腹泻型肠易激综合征患者和20名健康志愿者参与到了本研究。所有受试者接受并顺利完成了相关检查和问卷填写。利用恒压器（渐至极限法）检查我们发现腹泻型肠易激综合征患者具有肠道高敏感。同时,采用冷水刺激法和缺血刺激法探明腹泻型肠易激综合征患者具有躯体高敏感。重要结论：腹泻型肠易激综合征患者具有肠道和躯体高敏感、自主心血管功能紊乱以及肠道低浓度炎症。肠道高敏感和躯体高敏感、肠道高敏感和自主心血管功能紊乱、躯体高敏感和自主心血管紊乱之间存在相关性。

Visceral and somatic hypersensitivity,autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients

The pathophysiology of irritable bowel syndrome（IBS） is complex and not fully understood, so the aim of this study was to evaluate whether visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction, and low-grade inflammation of the gut wall are associated with diarrhea-predominant IBS（D-IBS）. Sixty-two patients with D-IBS and 20 control subjects participated in the study. Using the ascending method of limits（AML） protocol, we demonstrated that D-IBS patients had significantly lower sensory thresholds compared with healthy controls（P〈0.001）. Using diverse methods, especially the ischemic sensitivity test, for the first time in China, we confirmed that D-IBS patients have somatic hypersensitivity. They had a significantly higher systolic blood pressure and heart rate after a cold stimulus, indicative of autonomic cardiovascular dysfunction. Compared with the control group, D-IBS patients had a significantly higher level of calprotectin（P〈0.001）. We also found significant correlations between visceral and somatic hypersensitivity, visceral hypersensitivity and autonomic cardiovascular dysfunction, and somatic hypersensitivity and autonomic cardiovascular dysfunction. Our findings may provide valuable suggestions for the treatment of D-IBS.