摘要
目的探讨肠易激综合征(irritable bowel syndrome,IBS)是否存在内脏感知和胆囊收缩功能异常。方法选择2003年2月至2004年2月在中国医科大学附属第一医院消化内科就诊,诊断符合RomeⅡ标准的IBS患者76例,按是否有腹痛症状分为腹痛组40例,非腹痛组36例,按症状类型分为腹泻组18例、便秘组30例、腹泻与便秘交替组28例;以30名健康志愿者为对照组。直肠初始感受容积和紧迫感阈值容积的测定采用直肠水囊容积试验。用实时超声图像检测空腹胆囊和进食后不同时间的胆囊容积。结果与对照组比较,IBS患者直肠容积的初始感受容积和紧迫感阈值容积明显降低。腹泻组、便秘组和腹泻便秘交替组IBS初始感受容积均低于对照组(P<0.01或P<0.05),腹痛组IBS患者的初始感受容积和紧迫感阈值容积明显低于非腹痛组(P<0.01)。IBS患者空腹胆囊容积、进餐后40min、60min和120min胆囊残余容量均高于对照组(均P<0.01)。IBS患者胆囊最大排空百分比显著大于对照组,最大收缩时间显著短于对照组(均P<0.01)。结论IBS患者内脏神经敏感性增加,可能是IBS发病的主要机制之一。IBS患者可能存在胆囊收缩功能异常。
Objective To investigate visceral perception and gallbladder contraction function in IBS patients. Methods A total of 76 cases were selected in the First Affiliated Hospital of China Medical University which were diagnosed as IBS cases. They were divided into 2 groups (40 and 36) according to the presence of abdominal pain;they were also divided into 3 groups according to symptomatic types, 18 in diarrhea group,30 in constipation and 28 in alternative diarrhea and constipation. The control group included 30 healthy volunteers. Measure the first sensation thresholds and the urge sensation of rectum water pocket volume. Use real-time supersonic image to measure the gallbladder volume before and after meal. Results Compared with normal groups, the first sensation thresholds of diarrhea-predominant IBS group was ( 33.00 ± 2. 02 ) mL vs ( 56.00 ± 4.04 ) mL, and the urge sensation was ( 86. 00 ± 4.53 ) mL vs ( 135.00 ± 3.55 ) mL, P 〈 0. 01 ;the first sensation thresholds of constipation-predominant IBS group and alternative of diarrhea and constipation group was 42. 00 ± 3.69 vs 56.00 ± 4.04, ( 38.00 ± 3.56 ) mL vs ( 56. 00 ± 4. 04 ) mL, and the urge sensations was (96.00 ±3.45) mL vs ( 135.00 ±3.55) mL, (102.00 ±4.78) mL vs (135.00 ±3.55)mL,P 〈0.05. Comparing the pain-predominant IBS with the IBS without pain, the first sensation thresholds was ( 26. 00 ± 2. 29 ) mL vs (42.00 ± 3.34 ) mL, P 〈 0. 05, and the urge sensation was ( 68. 00 ± 4. 20 ) mL vs ( 94. 00 ± 4. 37 ) mL, P 〈 0.01. The gallbladder volume before meal of IBS patients compared with normal group was ( 23.42 ± 4. 89) mL vs ( 16. 62 ± 5.91 ) mL, P 〈 0.01 ;40, 60,120 minutes after the gallbladder meal, remaining capacity was ( 13.25 ± 3.51 ) mL vs ( 7. 68 ± 2. 99 ) mL, P 〈 0. 01, ( 12. 12 ± 3.65 ) mL vs ( 8. 35 ± 2.96 ) mL, P 〈 0. 01, ( 15.55 ± 3.30 ) mL vs ( 9. 64 ± 3.02 ) mL, P 〈 0.01 respectively. The discharge rate was 56% vs 38% ,42% vs 53% ,26% vs 38% respectively. Compared with normal groups, the first sensation thresholds and the urge sensation of IBS was lower significantly. As to the gallbladder volume before meal, in IBS patients it was obviously higher than in normal groups. The gall- bladder remaining capacity in different times was also obviously higher than in normal groups. The discharge rate of gallbladder was lower than normal groups. Conclusion Visceral sensitivity increases in IBS patients, which may be an important pathogenesis of IBS. The function of gall-bladder contraction is probably abnormal in IBS patients.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第3期184-186,共3页
Chinese Journal of Practical Internal Medicine
基金
辽宁省自然科学基金[20042080]
关键词
肠易激综合征
内脏神经敏感性
胆囊收缩功能
irritable bowel syndrome
visceral hypersensitivity
gallbladder contraction function