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对结肠和直肠顺行性及逆行性紧张性反射的调节影响。

Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum.

作者信息

Ng Clinton, Danta Mark, Prott Gillian, Badcock Caro-Anne, Kellow John, Malcolm Allison

机构信息

Gastrointestinal Investigation Unit, Royal North Shore Hospital, University of Sydney, St. Leonards, New South Wales 2065, Australia.

出版信息

Am J Physiol Gastrointest Liver Physiol. 2004 Nov;287(5):G962-6. doi: 10.1152/ajpgi.00460.2003. Epub 2004 Jul 1.

Abstract

Tonic reflexes in the colon and rectum are likely to be important in health and in disorders of gastrointestinal function. The aim of this study was to evaluate the fasting and postprandial "colorectal" and "rectocolic" reflexes in response to 2-min isobaric distensions of the colon and rectum, accounting for enteric sensation, compliance, and distending balloon volume. In 14 healthy fasting subjects, a dual barostat assembly was positioned (descending colon and rectum). A 2-min phasic distension was performed in the colon and rectum in random order while the opposing balloon volume was recorded. Sensation (phasic distension) and compliance (ramp distension) were also determined. The experiment was repeated postprandially. Colonic distension resulted in significant rectal tonic contraction in the fasting (rectal volume change: -35.4 +/- 8.4 ml, P < 0.01) and postprandial (-22.2 +/- 8.4 ml, P < 0.01) states. After adjustment for colonic sensitivity, for compliance, and for distending balloon volume, the rectal volume change remained significant; the extent of the tonic response, however, correlated significantly with increasing pain score (P < 0.01). In contrast, rectal distension did not produce a significant tonic response in the colon (fasting: -6.5 +/- 7.3 ml; postprandial: 2.7 +/- 7.3 ml), either unadjusted or adjusted for rectal sensitivity, compliance, and distending balloon volume. In conclusion, the colorectal reflex, but not the rectocolic reflex, can be readily demonstrated both before and after a meal in response to a 2-min isobaric distension in the colon and rectum, respectively. Although the presence of the colorectal reflex does not depend on colonic sensitivity or the volume of the distending colonic balloon, these factors modulate the reflex, especially in the fasting state.

摘要

结肠和直肠的紧张性反射在健康状态以及胃肠功能紊乱中可能都很重要。本研究的目的是评估空腹和餐后“结肠 - 直肠”及“直肠 - 结肠”反射,该反射是对结肠和直肠进行2分钟等压扩张的反应,同时考虑肠道感觉、顺应性和扩张气囊体积。在14名健康的空腹受试者中,放置了一个双恒压器组件(降结肠和直肠)。以随机顺序对结肠和直肠进行2分钟的阶段性扩张,同时记录相对气囊的体积。还测定了感觉(阶段性扩张)和顺应性(斜坡扩张)。餐后重复该实验。结肠扩张在空腹(直肠体积变化:-35.4±8.4 ml,P<0.01)和餐后(-22.2±8.4 ml,P<0.01)状态下均导致显著的直肠紧张性收缩。在对结肠敏感性、顺应性和扩张气囊体积进行校正后,直肠体积变化仍然显著;然而,紧张性反应的程度与疼痛评分增加显著相关(P<0.01)。相比之下,直肠扩张在结肠中未产生显著的紧张性反应(空腹:-6.5±7.3 ml;餐后:2.7±7.3 ml),无论是未校正还是校正了直肠敏感性、顺应性和扩张气囊体积的情况。总之,结肠 - 直肠反射而非直肠 - 结肠反射,在进食前后分别对结肠和直肠进行2分钟等压扩张时均可轻易显示出来。尽管结肠 - 直肠反射的存在不依赖于结肠敏感性或扩张结肠气囊的体积,但这些因素会调节该反射,尤其是在空腹状态下。

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