与肠易激综合征相比，缓解期溃疡性结肠炎患者的肠易激综合征样症状：症状严重程度和炎症标志物

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurogastroenterology and Motility Pub Date : 2025-04-28 DOI:10.5056/jnm24010

Shikha Sahu, Anshika Varshney, Moni Chaudhary, Ujjala Ghoshal, Uday C Ghoshal

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引用次数: 0

摘要

背景/目的：溃疡性结肠炎缓解期（UC-R）患者可能会出现与肠易激综合征（IBS）一致的症状。本前瞻性研究旨在研究外周因素（如肠粘膜炎症）和中心因素（如心理状况）对IBS症状严重程度的相对影响，以评估(1)IBS症状严重程度评分（IBS- sss），(2)炎症标志物水平，以及(3)三组患者的心理合并症的存在：UC伴有IBS症状（UC-IBS）， UC- r无IBS患者和正常IBS个体。方法：UC-R患者采用Rome III和IV IBS标准（Mayo评分0分），并用IBS- sss测量症状严重程度。比较UC-R无IBS组、UC-IBS组和IBS组的血清和粪便炎症标志物。结果：UC-R患者中，31.3%（26/83）达到Rome III标准，9.6%（8/83）达到Rome IV标准。UC-IBS患者IBS- sss评分明显低于IBS患者(n = 50；167.5 [150-200] vs 255 [225-325]；P < 0.001)。UC-IBS的粪便钙保护蛋白水平高于UC-R或IBS (62.6 μg/g [34.1-85.6] vs 50.6 μg/g [27.3-96.6] vs 37.6 μg/g [12.1-62.3], P = 0.057)，而其他粪便标志物（乳铁蛋白和MMP-9）在UC-IBS和UC-R之间无显著差异。血清炎症标志物包括肿瘤坏死因子- α、白细胞介素-6、白细胞介素-10和粒细胞-巨噬细胞集落刺激因子、c反应蛋白在各组间相似。与UC-IBS相比，IBS患者报告的焦虑、疼痛、功能障碍和应对困难明显更高（均P < 0.001）， UC-R无IBS患者报告的水平最低。结论：三分之一和十分之一的UC-R患者分别符合罗马III和IV IBS标准。UC-IBS的IBS- sss低于IBS，粪钙保护蛋白高于IBS。心理合并症在IBS中更严重，在UC-R无IBS中最少，表明UC-IBS中更多的外周炎症和较少的中枢受累。

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Irritable Bowel Syndrome-like Symptoms in Patients With Ulcerative Colitis in Remission as Compared to Irritable Bowel Syndrome: Symptom Severity and Inflammatory Markers.

Background/aims: Patients with ulcerative colitis in remission (UC-R) may experience symptoms consistent with irritable bowel syndrome (IBS). This prospective study aims to examine the relative influence of peripheral factors, such as gut mucosal inflammation, and central factors, like psychological conditions, on the severity of IBS symptoms to evaluates (1) the IBS Symptom Severity Score (IBS-SSS), (2) levels of inflammatory markers, and (3) the presence of psychological comorbidities across 3 groups: UC patients with IBS symptoms (UC-IBS), UC-R patients without IBS, and individuals with usual IBS.

Methods: Rome III and IV IBS criteria were used in UC-R patients (Mayo score 0), with symptom severity measured by IBS-SSS. Serum and fecal inflammation markers were compared across UC-R without IBS, UC-IBS, and IBS groups.

Results: Among UC-R patients, 31.3% (26/83) met Rome III and 9.6% (8/83) met Rome IV IBS criteria. IBS-SSS scores were significantly lower in UC-IBS compared to IBS (n = 50; 167.5 [150-200] vs 255 [225-325]; P < 0.001). Fecal calprotectin levels were higher in UC-IBS than in UC-R or IBS (62.6 μg/g [34.1-85.6] vs 50.6 μg/g [27.3-96.6] vs 37.6 μg/g [12.1-62.3], P = 0.057), while other fecal markers (lactoferrin and MMP-9) showed no significant differences between UC-IBS and UC-R. Serum inflammatory marker including tumor necrosis factor-alpha, interleukin-6, interleukin-10, and granulocyte-macrophage colony-stimulating factor, C-reactive protein were similar across groups. Patients with IBS reported significantly higher anxiety, pain, functional impairment, and coping difficulties (all P < 0.001) compared to UC-IBS, with the lowest levels observed in UC-R without IBS.

Conclusions: One-third and one-tenth of UC-R patients met Rome III and IV IBS criteria, respectively. UC-IBS had lower IBS-SSS and higher fecal calprotectin than IBS. Psychological comorbidities were worse in IBS, least in UC-R without IBS, suggesting more peripheral inflammation and less central involvement in UC-IBS.

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来源期刊

Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY

CiteScore

6.30

自引率

8.80%

发文量

期刊介绍： Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.