肠易激综合征结肠动力与胃肠激素的相关性研究  

The study of the relationship between the motility of sigmoid colon and gastrointestinal hormones in patients with irritable bowel syndrome

作　　者：梁荣新[1] 蔡联英[1] 郑琴芳[1] 张法灿[1] 

机构地区：[1]广西壮族自治区人民医院消化内科,南宁530021

出　　处：《广西医学》2005年第4期479-482,共4页Guangxi Medical Journal

基　　金：广西留学回国人员科学基金资助项目(桂科回 9920013)

摘　　要：目的研究肠易激综合征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其关系.方法便秘型、腹泻型IBS组及对照组各13名,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,腹泻组乙状结肠动力指数(15.9±4.9)显著高于便秘组(10.9±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(218.7±76.5)升高的幅度更为显著,腹泻组的动力指数(86.5±53.4)显著高于便秘组(42.4±29.6).试餐后60 min,腹泻组乙状结肠动力指数(65.4±11.7),显著高于便秘组(19.8±14.5)和对照组(23.2±11.3).腹泻组血浆及乙状结肠黏膜中MTL含量显著高于对照组及便秘组患者(P<0.01);便秘组乙状结肠粘膜VIP的含量高于正常组及腹泻组(P<0.05),血浆中VIP各组间无明显差异(P>0.05);血浆及乙状结肠黏膜SS的含量在便秘组中显著高于对照组及腹泻组(P<0.01～0.05);血浆CCK在腹泻组也明显高于对照组及便秘组(P<0.05),在乙状结肠黏膜中各组间差异无显著性(P>0.05).空腹状态,乙状结肠黏膜MTL、CCK的含量与腹泻组乙状结肠动力指数呈正相关关系(r=0.332,P<0.05;r=0.63,P<0.05);乙状结肠黏膜VIP、SS的含量与便秘组乙状结肠动力指数呈负相关关系(r=-0.38,P<0.01;r=-0.724,P<0.01).结论胃肠激素在IBS的发病过程中起作用,不同类型IBS的乙状结肠运动功能的变化与不同类型胃肠激素密切相关.Objective To reveal the changes and of sigmoid colon motility and gastrointestinal hormones in patients with irritable bowel syndrome and their relationship.Methods 13 consitipation-predominant and sex/age mathched 13 diarrhea-predominant IBS patients and 13 healthy volunteers were enrolled in the experiment.Migrating and nonmigrating long spike bursts and motor index were recorded before and after a test meal by a water perfusing manometry apparatus connected with a computer.The contents of MTL,CCK,VIP and SS in plasm and sigmoid mucous membrance were measured by using radio-immunity.Results In fasting status,diarrhea-predominalnt IBS patients have higher motor index than that in other groups,The test meal significantly increased the motor index in all subjects,especially in the volunteers in the first half hour;the sigmoid motor index in diarrhea-predominant IBS patients is higher than that in consitipation-predominant IBS patients and in the volunteers in the first hour (P<0.01).In fasting status ,The contents of MTL in plasm and sigmoid mucous membrance of the diarrhea-predominant IBS patients is higher than that of the consitipation-predominant IBS patients and healthy subjects.The contents of VIP in sigmoid mucous membrance of the consitipation-predominant IBS patients is higher than that of the diarrhea-predominant IBS patients and healthy subjects (P<0.05),and the content of VIP in plasm is not significantly different in these groups (P>0.05).The contents of SS in plasm and sigmoid mucous membrance in IBS patients and in the volunteers (P<0.01、0.05).The contents of CCK in plasm of the diarrhea-predominant IBS patients is higher than that of the consitipation-predominant IBS patients and healthy subjects,but there are not significantly different in the content of CCK of sigmoid mucous membrance in these groups (P>0.05).In the fast state,the content of MTL and CCK of sigmoid mucous membrane have significantly positive correlation with motor index in the diarrhea-predominant IBS patients (r=0.332,P<0.05

关 键 词：肠易激综合征 胃肠激素 乙状结肠动力 

分 类 号：R574.62[医药卫生—消化系统]