中国人肛门直肠功能多中心检测参数正常值及其临床意义  

Normative values and its clinical significance of the anorectal manometry in Chinese from multi-center study

作　　者：孙晓红[1] 王智凤[1] 辛海威[1] 朱有玲[2] 王学勤[2] 罗金燕[2] 谢小平[3] 侯晓华[3] 邹多武[4] 柯美云[1] 

机构地区：[1]中国医学科学院北京协和医院消化科,100730 [2]西安交通大学第二附属医院消化科 [3]华中科技大学同济医学院附属协和医院消化科 [4]上海长海医院消化科

出　　处：《中华消化杂志》2014年第9期597-602,共6页Chinese Journal of Digestion

摘　　要：目的获得我国健康人不同年龄及性别肛门直肠动力及感觉功能参数的正常值。方法收集4个医疗中心的健康受试者，按年龄分为3组：Ⅰ组为18～39岁，Ⅱ组为40～59岁，Ⅲ组为≥60岁。应用气液压毛细灌注系统和 Pc Polygraf HR 台式高分辨消化道动力监测系统测定受试者静息状态下肛门括约肌参数；嘱受试者模拟排便，记录与排便相关的参数；最后向气囊充气评估直肠肛门抑制反射（RAIR）及直肠排便感知功能。采用单因素方差分析和独立样本 t 检验分别比较3个年龄组和不同性别受试者间的各项参数。结果共纳入健康受试者166名，Ⅰ组79名，其中男40名；Ⅱ组68名，其中男29名；Ⅲ组19名，男11名。肛门括约肌参数中3个年龄组间肛门括约肌长度（ASL）、有效肛门括约肌长度（VASL）、肛门括约肌静息压（RASP）、肛门括约肌最大缩榨压（SASP）及肛门括约肌有效缩榨压（VSASP）时限比较差异均无统计学意义（P 均＞0．05）。男性 SASP[（180．13±8．10）mmHg，1 mmHg＝0．133 kPa]明显高于女性[（143．93±6．59）mmHg，t＝-3．489，P ＝0．001]，其他参数差异均无统计学意义（P 均＞0．05）。排便相关参数中3个年龄组间模拟排便时直肠内压、直肠-肛门括约肌压力梯度（RAPG）、肛门括约肌松弛率（ASRR）及排便时直肠-肛门括约肌同步（RAC）比较差异均无统计学意义（P 均＞0．05）。男性模拟排便时直肠内压[（61．23±3．46）mmHg]和 RAPG[（40．04±4．08）mmHg]明显高于女性[（44．47±2．32）mmHg，t＝-4．075；（24．00±2．59）mmHg，t ＝-3．367，P 均＜0．01]，男女之间其他参数比较差异均无统计学意义（P 均＞0．05）。所有受试者 RAIR 均存在，3个年龄组及不同性别之间比较差异均无统计学意义（P 均＞0．05）。直肠排便感知功能中3个年龄组之间初始阈值（FRS）、排便阈值（CRS）Objective To acquire normative values of anorectal manometry and sensation in population of our country with different gender and age.Methods Healthy individuals from four medical centers were collected and divided into three group according to their age,group Ⅰ 18 - 39 years old, group Ⅱ 40-59 years old and group Ⅲ ≥60 years old.The parameters of anal of subjects at resting status was examined by pneumohydraulic capillary perfusion system and high resolution PC Polygraf HR＆amp;nbsp;desktop gastrointestinal dynamic monitoring system.Subjects were asked to simulate defecation and then the defecation related indexes were recorded.In the end rectoanal inhibitory reflexes （RAIR）and rectal sensation were assessed by aired balloon.One-way analysis of variance and independent sample test were performed to compare indexes among three groups with different age and between different genders. Results A total of 166 healthy subjects were enrolled,79 in group Ⅰ with 40 male,68 in group Ⅱ with 29 male and 19 in group Ⅲ with 11 male.There was no significant difference in anal sphincter length （ASL）,valid anal sphincter length （VASL）,resting anal sphincter pressure （RASP）,squeeze anal sphincter pressure （SASP）and duration of valid squeeze anal sphincter pressure （VSASP）among three groups with different age （all P 〉 0.05 ）.Compared between male and female,only SASP of male （（180.13±8.10）mmHg,1 mmHg=0.133 kPa）was significantly higher than that of female （（143.93± 6.59）mmHg,t = -3.489,P 〈0.001 ）,no difference in other parameters was found （all P 〉0.05 ）. There was no significant difference in rectal pressure （RP）,rectoanal pressure gradient （RAPG）,anal sphincter relaxation rate （ASRR）,and rectoanal coordination （RAC）among three groups （all P 〉0.05）. During simulated defecation,RP and RAPG of men （（61 .23±3.46）mmHg and （40.04±4.08）mmHg） were significantly higher than those of women （（44.47 ± 2.32）mmHg and （24.00 ± 2.

关 键 词：直肠肛门动力 直肠排便感知 直肠肛门抑制反射 性别 年龄 

分 类 号：R574[医药卫生—消化系统]