Simrén M, Castedal M, Svedlund J, Abrahamsson H, Björnsson E
Department of Internal Medicine, and Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg, Sweden.
Dig Dis Sci. 2000 Nov;45(11):2151-61. doi: 10.1023/a:1010770302403.
The propagation pattern of individual pressure waves in the gastroduodenal area in IBS is unexplored. We performed antroduodenojejunal manometry on 26 patients with IBS--13 with diarrhea predominant IBS (IBS-D) and 13 with constipation predominant IBS (IBS-C)--and 32 healthy controls. Neuropathic-like motor abnormalities were found in 38% of the patients with conventional manometric evaluation. With high-resolution analysis additional abnormalities were observed in the majority of the patients, with increased frequency of retrograde pressure waves postprandially in both IBS subgroups and in phase II in IBS-D. A correlation between subjective gastrointestinal symptoms and the frequency of retrograde pressure waves in phase II in IBS-D was demonstrated. Motility indices and the number of long clusters were also higher in patients compared to controls. To conclude, an abnormal propagation pattern of individual duodenal pressure waves in IBS patients was demonstrated and found to be related to symptom severity in diarrhea-predominant IBS. High-resolution analysis adds information to standard manometry.
肠易激综合征(IBS)患者胃十二指肠区域单个压力波的传播模式尚未得到研究。我们对26例IBS患者——13例腹泻型肠易激综合征(IBS-D)患者和13例便秘型肠易激综合征(IBS-C)患者——以及32名健康对照者进行了十二指肠空肠测压。在传统测压评估中,38%的患者存在类神经病变样运动异常。通过高分辨率分析,在大多数患者中观察到了额外的异常情况,两个IBS亚组餐后逆行压力波频率均增加,且IBS-D患者在Ⅱ期也增加。IBS-D患者主观胃肠道症状与Ⅱ期逆行压力波频率之间存在相关性。与对照组相比,患者的运动指数和长簇数量也更高。总之,已证明IBS患者十二指肠单个压力波的传播模式异常,且发现其与腹泻型肠易激综合征的症状严重程度相关。高分辨率分析为标准测压增加了信息。