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[超声检查对肠易激综合征患者乙状结肠的评估]

[Ultrasonographic assessment of sigmoid colon in patients with irritable bowel syndrome].

作者信息

Kusunoki Hiroaki, Kamada Tomoari, Sato Motonori, Haruma Ken, Hata Jiro

机构信息

Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School.

出版信息

Nihon Rinsho. 2006 Aug;64(8):1461-6.

Abstract

UNLABELLED

Although the pathophysiological factors may play a role in the pathogenesis of irritable bowel syndrome (IBS), the function of sigmoid colon has been reported as a major pathogenesis of IBS. Our objective was to evaluate motility patterns of sigmoid colon by using ultrasonography(US) in patients with IBS compared to healthy volunteers (HV). SUBIECTS AND METHODS: US examination of sigmoid colon was performed in 69 patients with IBS and 69 HV with 3.75 MHz curved array scanner and 7.5 MHz linear array scanner. The US probe was positioned longitudinally to permit simultaneous visualization of sigmoid colon crossing over the iliopsoas. We classified 3 types of fasting sigmoid colon, spastic type, empty type, and normal type, according to the US findings. Four IBS patients with diarrhea, 4 with constipation and 4 HV were given the liquid test meal (200ml, 400kcal). The frequency of segmental contractions (contractions without propagation) and propulsion were evaluated by US in the same fashion for 30 minutes before and for 60 minutes after investigation.

RESULTS

Sixty-two percent of IBS showed spastic type and 65% of HV showed normal type. IBS patients accounted for 80 % of spastic type (IBS vs spastic type of US findings: Sensitivity 62%, Specificity 91%). The changes of frequency of segmental contractions were smaller in IBS patients with constipation. The changes of frequency of propulsion were larger in IBS patients with diarrhea.

CONCLUSION

Ultrasonographic assessment of sigmoid colon may provide a better understanding of the pathogenesis of IBS.

摘要

未标记

尽管病理生理因素可能在肠易激综合征(IBS)的发病机制中起作用,但据报道乙状结肠功能是IBS的主要发病机制。我们的目的是通过超声检查(US)评估IBS患者与健康志愿者(HV)相比乙状结肠的运动模式。

对象与方法

<禁食期> 对69例IBS患者和69例HV使用3.75MHz凸阵探头和7.5MHz线阵探头进行乙状结肠的超声检查。超声探头纵向放置,以便同时观察穿过髂腰肌的乙状结肠。根据超声检查结果,我们将禁食期乙状结肠分为3种类型:痉挛型、空虚型和正常型。<餐后阶段> 4例腹泻型IBS患者、4例便秘型IBS患者和4例HV给予液体试验餐(200ml,400千卡)。在检查前30分钟和检查后60分钟,以相同方式通过超声评估节段性收缩(无传播的收缩)频率和推进情况。

结果

<禁食期> 62%的IBS患者表现为痉挛型,65%的HV表现为正常型。IBS患者占痉挛型的80%(IBS与超声检查结果的痉挛型:敏感性62%,特异性91%)。<餐后阶段> 便秘型IBS患者节段性收缩频率变化较小。腹泻型IBS患者推进频率变化较大。

结论

乙状结肠的超声评估可能有助于更好地理解IBS的发病机制。

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