摘要
目的 :研究肠易激综合征 (IBS)患者乙状结肠动力及其血浆、乙状结肠黏膜中胃肠激素含量的变化及临床意义。方法 :符合 Rome II诊断标准的便秘型、腹泻型 IBS患者及对照组各 1 3例 ,分别采用液体灌注测压法记录空腹和进餐状态下乙状结肠的压力波形 ;采用放射免疫法测定血浆和乙状结肠黏膜胃动素 (MTL)、血管活性肠肽 (VIP)、生长抑素 (SS)、胆囊收缩素(CCK)含量。结果 :在空腹状态下 ,腹泻型 IBS组乙状结肠动力指数 (1 5 .9± 4 .9)显著高于便秘型 IBS组 (1 0 .9± 5 .6 )和对照组(9.4± 3.6 ) ,进食后 30 min内 ,对照组的乙状结肠动力指数 (2 1 8.7± 76 .5 )升高的幅度更为显著 ,腹泻组的动力指数 (86 .5±5 3.4 )改变幅度也显著高于便秘组 (4 2 .4± 2 9.6 )。试餐后第 6 0分钟 ,腹泻型 IBS组乙状结肠动力指数 (6 5 .4± 1 1 .7)升高的幅度显著高于便秘组 (1 9.8± 1 4 .5 )和对照组 (2 3.2± 1 1 .3)。腹泻型 IBS患者血浆及乙状结肠黏膜中 MTL 含量显著高于对照组及 IBS便秘型患者 (P <0 .0 1 ) ;便秘型 IBS患者乙状结肠黏膜 VIP的含量高于正常组及腹泻型 IBS(P <0 .0 5 ) ,而血浆中VIP各组间差异无统计学意义 (P >0 .0 5 ) ;血浆及乙状结肠黏膜 SS的含量在便秘型 IBS中显著高于对照组及腹泻型 (P
Objective:To reveal the changes and clinical significance of sigmoid colon motility and gastrointestinal hormones in patients with irritable bowel syndrome.Methods:13 consitipation predominant and sex/age mathched 13 diarrhea predominant IBS patients and 13 healthy volunteers were enrolled in the experiment. The pressure of sigmoid colon was recorded before and after a test meal by a water perfusing manometry apparatus connected with a computer.Result:In fasting status, diarrhea predominant IBS patients had higher motor index mainly due to the elevated wave amplitude and the percent of the recording time of the migrating long spike bursts. The test meal significantly increased the amplitude and the number of migrating and nonmigrating long spike bursts in all subjects, especially in the volunteers in the first half hour. The gastrocolic reflex of the diarrhea predominant IBS patients lasted longer than that of the consitipation predominant IBS patients . The plasma and sigmoid mucosa MTL are significantly higher in IBS with diarrhea than that in the normal group and IBS with constipation(P<0 01).The sigmoid mucosa VIP was significantly higher in the IBS with constipation than in the normal group and IBS with diarrhea(P<0 05),while the plasma VIP was not found to be significant in abnormality(P>0 05) . The plasma and sigmoid mucosa SS were significantly higher in IBS with constipation than that in the normal group and IBS with diarrhea(P<0 01~0 05). The plasma CCK was significantly higher in the IBS with diarrhea than that in the normal group and IBS with constipation(P<0 05),while the sigmoid mucosa CCK had no significant differences(P>0 05).Conclusion:Diarrhea predominant IBS patients have stronger sigmoid colon motility in fasting state; The gastrosigmoidocolic reflex appears earlier in healthy subjects than in IBS patients and it lasts longer in diarrhea predominant IBS patients than in consitipation predominant IBS patients and healthy subjects.
出处
《广西医科大学学报》
CAS
2003年第6期843-846,共4页
Journal of Guangxi Medical University
基金
广西自然科学资金资助项目 (桂科回 992 0 0 13 )
