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
發(fā)布時(shí)間：2019-01-23 22:02
【摘要】： 目的: 功能性消化不良(Functional dyspepsia,FD)是一組非常常見(jiàn)的臨床癥候群,患病率可達(dá)到11%～29.2%,患者生活質(zhì)量有顯著的下降,并造成了醫(yī)療資源的浪費(fèi)。FD的發(fā)病機(jī)制尚未完全闡明,目前認(rèn)為FD的發(fā)病與上胃腸道運(yùn)動(dòng)功能障礙、內(nèi)臟高敏感性、胃酸分泌過(guò)高、幽門螺桿菌感染、心理、社會(huì)、飲食等諸多因素及多種因素的綜合作用有關(guān)。Ghrelin是一種含有28個(gè)氨基酸的生長(zhǎng)激素釋放肽,瘦素(Leptin)是由肥胖基因(obese gene)編碼,脂肪細(xì)胞分泌的一種激素,作為新近發(fā)現(xiàn)的兩種腦腸肽它們對(duì)胃腸道的作用正逐漸被人們所認(rèn)識(shí)。精神心理因素對(duì)FD的發(fā)病起了重要的作用,尤其是焦慮和抑郁狀況。本文通過(guò)研究FD患者的血清Ghrelin及瘦素水平,焦慮及抑郁狀況,以期對(duì)這種疾病有進(jìn)一步的認(rèn)識(shí),為進(jìn)一步闡明其發(fā)病機(jī)制、尋找有效的治療方法提供依據(jù)。 方法: 選取44例FD患者并分成兩組:餐后不適綜合征(Postprandial distresssyndrome,PDS)組26人,上腹痛綜合征(Epigastric pain syndrome,EPS)組18人;及39例健康對(duì)照者,分別采用酶聯(lián)免疫法和放射免疫法進(jìn)行血清Ghrelin及瘦素水平檢測(cè);采用抑郁自評(píng)量表(Self-Rating Depression Scale,SDS)和焦慮自評(píng)量表(Self-Rating Anxiety Scale,SAS)進(jìn)行焦慮及抑郁狀況評(píng)價(jià);所得結(jié)果分別采用成組t檢驗(yàn),ANOVA單因素方差分析,Spearman相關(guān)分析,行×列表資料的χ~2檢驗(yàn)及交叉分類2×2表的關(guān)聯(lián)性分析。 結(jié)果: 1.FD組血清Ghrelin水平較對(duì)照組明顯減低(P＜0.01);其中PDS組血清Ghrelin水平較對(duì)照組明顯減低(P＜0.01),并且較EPS組也明顯減低(P＜0.05);而EPS組血清Ghrelin水平與對(duì)照組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。 2.FD組血清瘦素水平較對(duì)照組明顯減低(P＜0.05);其中PDS組血清瘦素水平較對(duì)照組明顯減(P＜0.01),并且較EPS組也明顯減低(P＜0.05);而EPS組血清瘦素水平與對(duì)照組比較的差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。 3.PDS組血清瘦素水平改變與血清Ghrelin水平改變之間呈正相關(guān)關(guān)系,而EPS組血清瘦素水平改變與血清Ghrelin水平改變之間不存在相關(guān)性。 4.FD組瘦素/Ghrelin與對(duì)照組兩組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05):PDS組、EPS組和對(duì)照組三組比較、三組間兩兩比較瘦素/Ghrelin的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。 5.FD組、PDS組、EPS組的SAS評(píng)分、SDS評(píng)分、焦慮人數(shù)比例、抑郁人數(shù)比例、合并焦慮與抑郁的人數(shù)比例均較對(duì)照組明顯增高;而PDS組與EPS組之間上述各項(xiàng)比較均無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05);SAS評(píng)分改變與SDS評(píng)分改變之間呈正相關(guān)關(guān)系;FD與SAS評(píng)分和SDS評(píng)分均存在正相關(guān)性。 6.FD組、PDS組、EPS組的血清Ghrelin、瘦素與SAS評(píng)分、SDS評(píng)分之間均不存在相關(guān)性(P＞0.05)。 結(jié)論: 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患者血清瘦素與Ghrelin之間存在正相關(guān)關(guān)系,提示血清Ghrelin和瘦素的變化對(duì)FD特別是PDS的發(fā)病起促進(jìn)作用,導(dǎo)致患者早飽,餐后飽脹不適等癥狀。 2.EPS患者血清Ghrelin和瘦素水平無(wú)明顯變化,提示血清Ghrelin和瘦素的變化可能與EPS的發(fā)病無(wú)明顯關(guān)系。 3.FD患者的SAS、SDS評(píng)分均增高,其中PDS和EPS患者的SAS、SDS評(píng)分也均增高,提示焦慮和抑郁情緒可能對(duì)FD的發(fā)病起促進(jìn)作用,對(duì)存在焦慮和抑郁情況的患者進(jìn)行相應(yīng)的治療會(huì)有療效。
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：R57;R395
本文編號(hào)：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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：R57;R395
【引證文獻(xiàn)】
相關(guān)期刊論文 前3條
1 蔡順天;王巍峰;楊云生;;ghrelin與功能性消化不良[J];胃腸病學(xué)和肝病學(xué)雜志;2011年06期
2 陳蘇寧;禮海;史業(yè)東;;胃痛消痞方對(duì)功能性消化不良大鼠血清及胃組織中Ghrelin、Leptin的影響[J];世界華人消化雜志;2010年26期
3 張維;張t ;;胃促生長(zhǎng)素與功能性消化不良的研究進(jìn)展[J];中國(guó)現(xiàn)代醫(yī)藥雜志;2011年07期
相關(guān)碩士學(xué)位論文 前2條
1 張紹杰;加味枳實(shí)消痞湯對(duì)功能性消化不良胃腸激素的影響[D];廣州中醫(yī)藥大學(xué);2013年
2 王春燕;清化和胃片治療餐后不適綜合征的臨床療效評(píng)價(jià)研究[D];中國(guó)中醫(yī)科學(xué)院;2013年
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