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作 者:刘谦民[1] 郑文尧[2] 郭荣斌[2] 杨云生[2]
机构地区:[1]解放军264医院,太原030001 [2]解放军总医院,北京100853
出 处:《北京军区医药》2001年第3期155-158,共4页
摘 要:目的 研究直肠肛管压力及胃肠激素的改变在肠易激综合征(IBS)发病中的作用,以及探讨胃肠激素与直肠肛管压力之间的关系。方法 采用五通道环状固态压力传感器测压导管测定43例IBS患者直肠肛管的压力,以及采用放射免疫分析法检测血浆胃泌素、胃动素、胰高糖素的水平,并与20例正常人作对照。结果 腹泻型IBS患者直肠静息压、肛管静息压较对照组高,便秘型IBS患者最大缩榨压较对照组低;腹泻型IBS患者的初始感觉量、排便感觉量、紧迫感觉量、最大耐受量均较正常对照组为低,而便秘型IBS患者均较对照组高;IBS患者各组血浆胃泌素及胃动素含量均高于对照组,血浆胰高糖素含量腹泻型IBS患者低于对照组,而便秘型IBS患者高于对照组;IBS患者的肛管括约肌静息压、最大缩榨压与血浆中胃动素的浓度呈正相关,IBS患者的初始感觉量、排便感觉量及最大耐受量与胰高糖素呈负相关。结论IBS患者的直肠肛管压力以及胃肠激素均异常。直肠肛管压力、直肠容量感觉能力与血浆胃肠激素含量呈正相关,直肠容量感知能力与血浆胃肠激素含量呈负相关。Objective To investigate the role of anorectal presure and plasma gastrointestinal hormones abnormality in irritable bowel syndrome (IBS)and the relationship between them. Methods 43 patients with IBS and 20 healthy subjects were comparatively investigated. Anorectal pressure was measured with anorectal catheta of solid state manometric transducers. Gastrointestinal hormones in plasma including gastrin (GAS), glucagen (GLU), were measured with radioim-munossay(RIA). Results Rectal resting presure (RRP) and anal sphincter resting presure (ARP) were significantly higher in the patients with diarrhea predominant type IBS(Dp-IBS)than in helthy subjects, and the MSQP was significantly lower in patients with constipation predominant type IBS (Cp-IBS) than in healthy subjects. The DSV, DUSV and MTVwere significantly lower in the patients with (Dp-IBS) than in healthy subjects, wheras FSV,DSV and DUSV were significantly higher in the patients with Cp -IBS compared with helthy subjects. The plasma levels of GAS and MTL in IBS patients were significantly higher than those in healthy subjects; plasma levels of plasma GAS and MTL in IBS patients were significantly higher than in helthy subjects, while the plasma concentration of GLU was significantly lower in patients with Dp-IBS and significantly higher in the patients with Cp-IBS when comparedwith healthy subjects; ARP and MSQP were positively correlated with plasma MTL in patients with IBS; DSV and MTV were negatively correlated with the plasma GLU in the patients. Conclusions Anorectal pressure and gastrointestinal hormones were abnormal in patients with IBS. Anorectal pressuer was positively correlated with concentration of gastrointestinal hormones in plasma.
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