功能性便秘和便秘型肠易激综合征患者的直肠顺应性  

Rectal Compliance in Patients with Functional Constipation and Constipation-predominant Irritable Bowel Syndrome

作　　者：查慧[1] 谢小平[1] 侯晓华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院消化内科

出　　处：《胃肠病学》2006年第8期488-491,共4页Chinese Journal of Gastroenterology

摘　　要：背景:直肠顺应性是直肠运动的重要特征,其改变可能是便秘的重要病理生理机制之一。目的:研究不同类型便秘患者直肠感觉和顺应性的差异,了解直肠顺应性的临床意义。方法:应用恒压器(barostat),以500ml聚乙烯球囊对直肠进行快速位相性扩张,检测功能性便秘(FC)和便秘型肠易激综合征(C-IBS)患者的直肠感觉和顺应性,并与正常对照者进行比较。结果:FC和C-IBS组的直肠顺应性较正常对照组显著降低(6.34ml/mmHg±2.26ml/mmHg和6.50ml/mmHg±2.48ml/mmHg对9.57ml/mmHg±2.77ml/mmHg,P<0.05),但两组间差异无显著性。直肠感觉过敏便秘患者的顺应性明显增高,但FC和C-IBS组感觉与顺应性的关系并不完全相同。结论:一些便秘患者对直肠扩张感觉异常可能部分系由直肠顺应性改变所致,根据直肠顺应性结合感觉变化可以更好地区分不同类型的便秘。Background： Rectal compliance is considered an important feature of rectal motor function, and may be one of the main pathophysiologic factors in the pathogenesis of constipation. Aims： To investigate the differences in the rectal sensation and rectal compliance in patients with different subtypes of constipation, and to understand the clinical significance of rectal compliance. Methods： Using a computerized barostat with a 500 ml polyethylene balloon, the visceral sensation and compliance in the rectum were determined in patients with functional constipation （FC）, constipation-predominant irritable bowel syndrome （C-IBS） and normal controls. The pressure was controlled by rapid phasic distention. Results： The rectal compliance was significantly decreased in FC and C-IBS patients than that in the normal controls （6.34 ml/mm Hg±2.26 ml/mm Hg and 6.50 ml/mm Hg±2.48 ml/mm Hg vs. 9.57 ml/mm Hg±2.77 ml/mm Hg, P〈0.05）, but no difference was found between that in FC and C-IBS patients. The rectal compliance was significantly increased in patients with rectal hypersensitivity, however, the relationship between rectal sensation and rectal compliance in FC and C-IBS patients were not consistent. Conclusions： Impaired perception of rectal distension may be partially explained by abnormal rectal compliance in some constipation patients. Basing on the changes of rectal compliance and rectal sensation, one may be able to differentiate the different subtypes of constipation.

关 键 词：结肠疾病 功能性 便秘 肠易激综合征 直肠顺应性 直肠感觉 

分 类 号：R574.62[医药卫生—消化系统] R574[医药卫生—内科学]