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十二指肠炎症与功能性胃肠病症状重叠的研究进展*黄智炜颜秀娟陈胜良#上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所（200001）摘要症状重叠是功能性胃肠病（FGIDs ）常见的临床现象，其治疗主要基于促动力和改善内脏敏感性，但疗效有限。
近期发现功能性消化不良（FD ）患者十二指肠普遍存在以嗜酸性粒细胞浸润为主的低度炎症，伴随上皮完整性受损、通透性增高、细胞焦亡增加等改变，尤其是在FD 重叠胃食管反流病（GERD ）和（或）肠易激综合征（IBS ）的患者中。
FGIDs 的病因包括感染、应激、食物抗原、饮食节律紊乱等，可通过激活十二指肠黏膜嗜酸性粒细胞⁃肥大细胞轴，增加黏膜通透性，参与肠⁃脑互动，导致FGIDs 症状及其重叠。
本文就十二指肠炎症与FGIDs 症状重叠的研究进展作一综述。
关键词功能性胃肠病；症状重叠；十二指肠炎症；嗜酸性粒细胞；肥大细胞；肠⁃脑互动Advances in Research on Duodenal Inflammation and Overlapping Symptoms of Functional Gastrointestinal DisordersHUANG Zhiwei,YAN Xiujuan,CHEN Shengliang.Division of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University;Shanghai Institute of Digestive Disease,Shanghai (200001)Correspondence to:CHEN Shengliang,Email:****************AbstractOverlapping symptoms are common in functional gastrointestinal disorders (FGIDs).The treatment ofFGIDs is based on promoting gastrointestinal motility and improving visceral hypersensitivity,however,the efficacy is limited.Emerging data suggest the presence of low⁃grade duodenal inflammation with predominant eosinophilic infiltration in functional dyspepsia (FD)patients,accompanied by impaired epithelial barrier,increased permeability and increased pyroptosis,etc.,especially in FD patients overlapping gastroesophageal reflux disease (GERD)and/or irritable bowel syndrome (IBS).The etiologies of FGIDs include infection,stress,food antigens,irregular diet etc.,and can increasemucosal permeability,involve in the gut⁃brain interaction via activating duodenal mucosal eosinophil⁃mast cell axis,thuscausing the symptoms of FGIDs as well as the overlapping symptoms.This article reviewed advances in research on duodenal inflammation and overlapping symptoms of FGIDs.Key wordsFunctional Gastrointestinal Disorders;Overlapping Symptoms;Duodenal Inflammation;Eosinophils;Mast Cells;Gut⁃Brain InteractionDOI ：10.3969/j.issn.1008⁃7125.2023.02.009*基金项目：国家自然科学基金面上项目（81970472）#本文通信作者，Email:****************功能性胃肠病（functional gastrointestinal disorders,FGIDs ）是一组慢性、反复发作的胃肠道症状，常规检查（包括消化内镜）未能发现能够解释症状的成因。
