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目的 研究IBS患者在空腹和进食状态下乙状结肠动力的改变。方法 符合RomeⅡ诊断标准的便秘型和腹泻型IBS患者各 2 0名及对照组 1 5名 ,分别采用液体灌注测压法记录空腹和进餐状态下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 (1 5 9± 4 9)显著高于便秘型IBS组 (1 0 9± 5 6 )和对照组 (9 4± 3 6 ) ,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。进食后 30min内 ,对照组的乙状结肠动力指数 (2 1 8 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 )。试餐后第 6 0min ,腹泻型IBS组乙状结肠动力指数 (6 5 4± 1 1 7)升高的幅度显著高于便秘组 (1 9 8± 1 4 5 )和正常组 (2 3 2± 1 1 3)。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 ,持续时间较长。便秘型IBS患者胃结肠反射强度弱且消失快 ;健康人胃结肠反射出现较早且持续时间较短
Objective To study the changes of sigmoid motility in fasting and feeding IBS patients. Methods Twenty patients with constipation and diarrhea-type IBS with Rome II diagnostic criteria and 20 normal controls were enrolled in this study. Liquid perfusion manometry was used to record high-amplitude sudden waves of sigmoid colon transition in fasting and meal states, respectively, with high non-migratory Amplitude of the sudden wave amplitude and the percentage change of the recording time; Compare the dynamic index before and after the sigmoid colon. Results In the fasting state, the sigmoid colon dynamic index (IBS) of diarrhea type IBS group was significantly higher than that of constipation IBS group (109 ± 56) and control group (94 ± 36), the main manifestations were The amplitude and duration of high-amplitude transitional wave in transitional period were prolonged, and the duration of non-migratory high-amplitude burst wave in constipation-type IBS group was also significantly prolonged. Within 30 min after feeding, the amplitude of sigmoid dynamic index (2 1 8 7 ± 76 5) in the control group was more significant, and the dynamic index (86 5 ± 5 3 4) of the diarrhea group was significantly higher than that of the constipation group 4 2 4 ± 2 9 6). At 60 minutes after the meal, the amplitude of sigmoid colon dynamic index (6 5 4 ± 1 1 7) in diarrhea IBS group was significantly higher than that in constipation group (1 98 ± 1 4 5) and normal group (2 3 2 ± 1 1) 1 3). Conclusions In the fasting state, sigmoid colon movement is enhanced in patients with diarrhea-type IBS. Gastrocolic reflex is mainly accompanied by increased peristalsis, which occurs later and lasts longer. Constipation IBS patients with weak and disappeared gastrointestinal reflex; healthy people appeared earlier and shorter duration of gastrointestinal reflex