肠易激综合征病人肠道气体定量分析

Quantitative analysis of bowel gas in patients with irritable bowel syndrome

目的 通过X线腹部平片对肠道气体进行定量测试 ,分析肠道气体容量与肠易激综合征(IBS)的关系。方法 4 8例根据罗马Ⅱ标准诊断的IBS病人和 2 5例正常对照的X线腹部平片经数字化转换后输入电脑 ,肠道气体量在电脑显示为象素值 ,经体格标准化后 ,以气体容量积分 (GVS)表达。以对照GVS的 x± 2s为正常值 ,分析GVS与IBS型别的关系。结果 正常对照GVS为 0 .0 5 5±0 .0 12 ,离散系数为 2 1.8% ;便秘型IBS均值 (0 .0 76± 0 .0 2 7,t =3.5 99,P <0 .0 1)与正常人比较显著增高 ,4 4 .4 %的个体GVS大于正常值 ,余在正常范围 ;腹泻型IBS均值 (0 .0 4 8± 0 .0 32 ,t =1.4 76 ,P >0 .0 5 )与正常人比较差异无显著性 ,但离散系数高达 6 6 .7% ,4 2 .9%的病人GVS降低 ,14 .3%增高。结论 IBS病人肠道气体容量存在明显改变 ,并与型别有关 ;便秘型以增多为主 ,腹泻型以减少为主。

Objective To study the relationship between irritable bowel syndrome (IBS) and the quantity of bowel gas using plain abdominal radiographs. Methods Plain abdominal radiograph were digitized and transmitted to a computer in 48 IBS patients and 25 normal controls. The quantity of bowel gas, determined as the pixel value on images and standardized by physique, was defined as the gas volume score (GVS). The ±2s of GVS in the control group was used as the normal score. The relationship between GVS and subtype of IBS was analyzed. Results The mean GVS of normal control was 0.055±0.012, and coefficient of variation was 21.8%, and all subjects were in normal score. The mean GVS was 0.076±0.027 for the constipation type IBS, significantly higher than that for control ( t =3.599, P <0.01). High score was seen in 44.4% of patients, and normal score for the rest. There was no significant statistic difference between the diarrhea type IBS (0.048±0.032, t =1.476, P >0.05) and the control in the mean GVS. However, the coefficient of variation in the diarrhea type IBS was as high as 66.7%, and low score was seen in 42.9% of patients and high score in 14.3%.Conclusions There is a significant subtype related change of bowel gas volume in IBS patients. The bowel gas is increased in the constipation type, and decreased markedly in the diarrhea type.