肠易激综合征患者小肠移行性复合运动的研究  

A research of migrating motor complex in patients with irritable bowel syndrome

作　　者：王深皓[1] 董蕾[1] 罗金燕[1] 李路[1] 朱有玲[1] 王学勤[1] 邹百仓[1] 龚均[1] 

机构地区：[1]西安交通大学医学院第二附属医院消化科,710004

出　　处：《中华内科杂志》2009年第2期106-110,共5页Chinese Journal of Internal Medicine

基　　金：卫生部临床学科重点项目（2004-54）

摘　　要：目的了解肠易激综合征（IBS）患者移行性复合运动（MMC）与健康人相比是否有差异及IBS患者离散性丛集波（DCC）与腹痛是否有关。同时改进目前胃肠运动的监测方法。方法采用16导水灌注测压导管对16例便秘型IBS（IBS—C）患者、18例腹泻型IBS（IBS—D）患者、18例健康对照者进行MMC的监测。结果IBS—C[（127．5±25．5）min]及IBS—D患者[（74．5±18．7）min]MMC周期持续时间与健康对照组[（87．5±24．2）min]相比存在显著不同（P值均〈0．001）。与健康对照者相比，IBS—C患者MMCⅢ相波幅及传播速度显著降低[（39．8±11．7）mmHg比（61．1±14．1）mmHg，P〈0．001，1mmHg：0．133kPa；（1．8±0．9）cm／min比（2．6±0．8）cm／min，P〈0．01]；而IBS—D患者MMCⅢ相波幅[（69．7±20．5）mmHg]升高，MMCⅢ相传播速度[（4．1±2．5）cm／min]显著加快。IBS—C、IBS-D患者及健康对照组MMCⅡ相DCC发生率分别为87．5％，88．8％，83．3％，各组之间差别无统计学意义（P〉0．05）。IBS—C及IBS—D患者MMCⅢ相波中断、传导障碍等异常现象发生率分别为68．8％、66．7％，且只在空肠部位观察到，而健康人中未见到该异常。结论（1）IBS-C、IBS—D患者的MMC与健康人相比有明显差异，提示MMC运动异常是IBS重要发病机制之一，而且IBS患者空肠部位MMCⅢ相波的变化可能是IBS重要的胃肠道运动异常。（2）DCC与IBS患者腹痛无明显相关性。Objectives To compare the migrating motor complex （MMC） in irritable bowel syndrome （IBS） patients with that in healthy controls. To explore whether discrete clustered contractions （DCC） are connected with abdominal pain in IBS patients. To improve the method of measuring gastroenteric motility （esp. jejunum）. Methods By using 16-channel water-perfused catheter and manometry instruments, MMC in 16 cases of IBS with constipation （1BS-C）, 18 cases of IBS with diarrhea （IBS-D） and 18 cases of healthy controls were monitored. Results The MMC durations of ]BS-C and IBS-D patients were （127.5±25.5） min and （74. 5 ± 18.7） min, respectively. Comparision with those in the control group [ （87.5 ±24. 2 ） min ] showed significant differences （ P 〈 0. 001 ）. The contraction amplitudes of stage Ⅲ in different sites of IBS-C patients decreased significantly as compared with those in the controls [jejunum, （39.8±11.7） mm Hgvs. （61.1 ±14.1） mmHg,P〈0.001,1 mm Hg=0.133 kPa]. The propagation velocities of stage Ⅲ in different sites of IBS-C patients also decreased significantly as compared with those in the controls [ jejunum, （ 1.8 ± 0. 9） cm/min vs. （2. 6 ± 0. 8 ） cm/min, P 〈 0. 01 ]. The contraction amplitudes of stage Ⅲ in different sites of IBS-D patients increased significantly as compared with those in the controls [jejunum, （69.7 ±20.5） mm Hg vs. （61.1 ±14.1） mm Hg,P〈0. 01]. The propagation velocities of stage Ⅲ in different sites of IBS-D patients also increased significantly as compared with those in the controls [ jejunum, （4. 1 ± 2. 5 ） cm/min vs. （2. 6 ± 0. 8 ） cm/min, P 〈0. 01 ]. DCC incidences of IBS-C and IBS-D were 87.5% and 88.8% , respectively. Comparision with those in the normal group （ 83.3% ） did not show significant difference （ P 〉 0.05 ）. The prevalences of abnormal stage Ⅲ contractions （include disturbances and interferences of stage Ⅲ contractions） in IBS-C and IBS-D patients were 68. 8%

关 键 词：肠易激综合征 胃肠道测压 移行性复合运动 

分 类 号：R686[医药卫生—骨科学]