Russo A, Botten R, Kong M-F, Chapman I M, Fraser R J L, Horowitz M, Sun W-M
Department of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia.
Diabet Med. 2004 Feb;21(2):176-82. doi: 10.1111/j.1464-5491.2004.01106.x.
To determine the effects of acute hyperglycaemia on anorectal motor and sensory function in patients with diabetes mellitus.
In eight patients with Type 1, and 10 patients with Type 2 diabetes anorectal motility and sensation were evaluated on separate days while the blood glucose concentration was stabilized at either 5 mmol/l or 12 mmol/l using a glucose clamp technique. Eight healthy subjects were studied under euglycaemic conditions. Anorectal motor and sensory function was evaluated using a sleeve/sidehole catheter, incorporating a barostat bag.
In diabetic subjects hyperglycaemia was associated with reductions in maximal (P<0.05) and plateau (P<0.05) anal squeeze pressures and the rectal pressure/volume relationship (compliance) during barostat distension (P<0.01). Hyperglycaemia had no effect on the perception of rectal distension. Apart from a reduction in rectal compliance (P<0.01) and a trend (P=0.06) for an increased number of spontaneous anal sphincter relaxations, there were no differences between the patients studied during euglycaemia when compared with healthy subjects.
In patients with diabetes, acute hyperglycaemia inhibits external anal sphincter function and decreases rectal compliance, potentially increasing the risk of faecal incontinence.
确定急性高血糖对糖尿病患者肛门直肠运动和感觉功能的影响。
对8例1型糖尿病患者和10例2型糖尿病患者，在不同日期使用葡萄糖钳夹技术将血糖浓度稳定在5 mmol/l或12 mmol/l时，评估其肛门直肠运动和感觉。对8名健康受试者在正常血糖条件下进行研究。使用带有恒压器袋的袖套/侧孔导管评估肛门直肠运动和感觉功能。
在糖尿病受试者中，高血糖与最大（P<0.05）和平台期（P<0.05）肛门挤压压力降低以及恒压器扩张期间直肠压力/容积关系（顺应性）降低相关（P<0.01）。高血糖对直肠扩张的感知没有影响。与健康受试者相比，在正常血糖期间研究的患者除了直肠顺应性降低（P<0.01）和自发性肛门括约肌松弛次数增加的趋势（P=0.06）外，没有其他差异。
在糖尿病患者中，急性高血糖会抑制肛门外括约肌功能并降低直肠顺应性，可能增加大便失禁的风险。
