便秘型肠易激综合征患者直肠肛管压力的改变与焦虑/抑郁情绪测定评分的临床意义

Clinical value of rectal pressure change and anxiety/depression scores in patients with constipation-dominant irritable bowel syndrome

[目的]探讨便秘型肠易激综合征(IBS-C)患者直肠肛管压力的变化及其与焦虑/抑郁情绪测定评分的关系与意义。[方法]选择确诊为IBS-C的患者70例为试验组、健康志愿者24例作为对照组,采用肛管直肠测定仪进行动力学检查,并采用综合医院焦虑/抑郁情绪测定表进行心理状况评估,比较2组直肠肛管的压力和情绪测定评分的差异。[结果]试验组患者直肠初始感觉阈值、初始排便感觉阈值、直肠最大容量感觉阈值均高于对照组(P<0.05);试验组直肠肛门抑制反射阈值和肛管静息压高于对照组,但2组比较差异无统计学意义(P>0.05);试验组肛管最大自主收缩压低于对照组、焦虑评分与抑郁评分显著高于对照组(均P<0.05)。[结论]IBS-C患者存在明显的直肠感觉功能的障碍和盆底肌协调运动障碍,且存在焦虑抑郁症状,为临床诊治提供了依据。

[Objective]To investigate the changes of anorectal pressure and the level of anxiety and depression score in patients with constipation-dominant irritable bowel syndrome（IBS-C）.[Methods]Seventy patients with IBS-C and 24 healthy volunteers without defecation disorder in our hospital were selected as experiment group and control group.Anorectal manometry was used for the examination of anorectal motility and Hospital Anxiety and Depression Scale（HADS）was used to evaluate the mental states.The anorectal pressure and scores of anxiety and depression were compared between two groups.[Results]The initial rectal sensation threshold,initial defecation sensation threshold,and the rectal maximum volume threshold in IBS-C group were significantly higher than those in the control group（P＜0.05）.The Anorectal inhibitory reflex threshold（RAIR）and the resting pressure in IBS-C group were higher than those in the control group,but there was no statistical significance between two groups（P＞0.05）.The maximal pressure of anal voluntary contraction in IBS-C group were lower than those in the control group（P＜0.05）.Anxiety and depression scores in IBS-C group were significantly higher than those in the control group（P＜0.05）.[Conclusion]IBS-C patients have obvious decreasing of rectal sensation and the disorder of coordinated motion of pelvic floor muscle and also have anxiety and depression.It is helpful to provide the basis of clinical diagnosis and treatment.