肠易激综合征患者进食前后乙状结肠动力差异的研究  

Pre-and post-prandial changes of sigmoid colon motility in patients with irritable bowel syndrome

作　　者：梁荣新[1] 张志雄[1] 张法灿[1] 蔡联英[1] 郑琴芳[1] 梁列新[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：《中国实用内科杂志》2004年第4期205-207,共3页Chinese Journal of Practical Internal Medicine

基　　金：广西留学回国人员基金资助 (桂科回 992 0 0 13 )

摘　　要：目的　研究肠易激综合征 (IBS)患者和健康人在空腹和进食状态下不同时段乙状结肠动力的改变。方法　符合罗马Ⅱ诊断标准的便秘主导型和腹泻主导型IBS患者各 2 0例及年龄性别匹配的健康志愿者 15名(男、女分别为 7、8名 ) ,分别采用液体灌注测压法记录空腹和进食试餐状态下不同时段乙状结肠移行性高幅突发波、非移行性高幅突发波的波幅及占记录时间百分比的变化 ;比较乙状结肠在进食前后的动力指数。结果　在空腹状态下 ,腹泻型IBS组乙状结肠动力指数 (15 9± 4 9)显著高于便秘型IBS组 (10 9± 5 6 )和对照组 (9 4± 3 6 )(P <0 0 5 ) ,主要表现为移行性高幅突发波的波幅和持续时间延长 ,便秘型IBS组非移行性高幅突发波持续时间也显著延长 (P <0 0 5 )。进食试餐后 30min内 ,健康组的乙状结肠动力指数 (2 18.7± 76 .5 )升高的幅度更为显著 ,腹泻组的动力指数 (86 5± 5 3 4 )改变幅度也显著高于便秘组 (4 2 4± 2 9 6 ) (P <0 0 5 )。试餐后 31～ 6 0min ,腹泻型IBS组乙状结肠动力指数 (6 5 4± 11 7)升高的幅度显著高于便秘组 (19 8± 14 5 )和正常组 (2 3 2± 11 3) (P <0 0 5 )。结论　空腹状态下 ,腹泻型IBS患者乙状结肠推进性运动增强 ;胃结肠反射主要表现为蠕动性收缩增强 ,发生较晚?Objective To reveal the changes of pre-and post-prandial sigmoid colon motility in irritable bowel syndrome (IBS) patients and healthy comtrols.Methods Twenty consitipation-predominant and sex/age mathched 20 diarrhea-predominant IBS patients and 15 healthy volunteers were enrolled in the experiment.Migrating long spike bursts,and nonmigrating long spike bursts were recorded by a water perfusing manometry apparatus connected with a computer.Results In fasting status,diarrhea-predominant IBS patients had higher motor index mainly due to the elevated wave amplitude and the percentage of the recording time of the migrating long spike bursts.The test meal significantly increased the amplitude and the number of migrating and nonmigrating long spike bursts in all subjects,especially in the volunteers in the first half hour.The gastrosigmoidocolic reflex of the diarrhea-predominant IBS patients lasted longer than that of the consitipation-predominant IBS patients and healthy controls,mainly due to the increased amplitude of migrating long spike bursts and the number of nonmigrating long spike bursts.Conclusion Diarrhea-predominant IBS patients have stronger sigmoid colon motility in fasting state.The gastrosigmoidocolic reflex appears earlier in healthy subjects than in IBS patients and it lasts longer in diarrhea-predominant IBS patients than in consitipation-predominant IBS patients and healthy controls.

关 键 词：肠易激综合征 乙状结肠动力 IBS 结肠反射 

分 类 号：R574[医药卫生—消化系统]