腹泻型与便秘型肠易激综合征直肠肛管动力和感觉功能的不同特点

Study on anorectal dynamics and rectal sensory function in patients with irritable bowel syndrome

目的 研究腹泻型与便秘型肠易激综合征（IBS）病人直肠肛管动力和直肠感觉功能的不同特点。方法 选择IBS病人85例，分成两组。其中腹泻组52例，便秘组33例，20例健康志愿者为对照组，采用PC Polygraf ID高分辨率多道胃肠功能测定仪，分别测定直肠肛管压力、直肠感知阈值、排便阈值、最大耐受量和直肠肛门抑制反射最低充气量。结果IBS病人的直肠静息压、肛管静息压和直肠肛门抑制反射最低充气量与健康对照组比较无显著性差异。腹泻组的最大缩窄压和排便阈值显著低于健康对照组。便秘组的松弛压、直肠感知阈值、排便阈值和最大耐受量显著高于健康对照组。结论腹泻型IBS病人的症状与最大缩窄压和排便闽值降低有关；而便秘型则与松弛压、直肠感知阈值、排便阈值和最大耐受量显著增高有关。

AIM To study the different characteristics of anorectal dynamics along with the rectal sensory function in patients with diarrhea - predominant or constipation- predominant irritable bowel syndrome （IBS）. METHODS 85 patients with IBS were divided into twogroups that were 52 cases in the diarrhea - predominant group and 33 cases in the constipation - predominant group; 20 healthy subjects were employed as controls. A multichannel and single- balloon anorectal function detector PC Polygraf ID was applied for measurement of rectal dynamic and sensory parameters including anorectal pressure, rectal sensation volume thresholds, rectal defecation volume thresholds, rectal maximum tolerable volume thresholds and minimum relaxation volume. RESULTS There were no significant differences in rectalresting pressure, anal resting pressure and minimum relaxation volume between the patient with IBS and normal subjects, But the anorectal sphincteric squeezingp ressure and rectal defecation volume thresholds were signifi- cantly lower in the diarrhea- predominant group than in normal subjects. The relaxation pressure, rectal sensation volume thresholds, rectal defecation volume thresholds and rectal maximum tolerable volume thresholds were significantly higher in the constipationpredominant group than in normal subjects. CONCLUSION Symptoms of diarrhea in diarrhea- predominant IBS are related to decreased anorectal sphincteric squeezing pressure and rectal defecation volume thresholds while in constipation- predominant IBS, to significantly increased relaxation pressure, rectal sensation volume thresholds, rectal defecation volume thresholds and rectal maximum tolerable volume thresholds.