Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S
Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota.
Gastroenterology. 1991 Jul;101(1):107-15. doi: 10.1016/0016-5085(91)90466-x.
In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO) with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon ("pancolonic inertia"); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. Transit delays in other parts of the gut suggest that, in some patients, the condition may be a more generalized motor dysfunction.
在本研究中，采用闪烁扫描法测量特发性便秘患者的全肠道转运和结肠区域转运。对8例严重便秘患者进行了研究，这些患者均无盆底功能异常的证据。使用含混合餐的99mTc放射性标记的Amberlite树脂颗粒（平均直径1毫米；西格玛化学公司，密苏里州圣路易斯）评估胃排空和小肠转运；将含111In标记的类似颗粒装入在回盲部区域分散的包衣胶囊中服用，用于量化结肠转运。还对5名健康志愿者进行了研究。2例患者胃排空延迟，2例小肠转运缓慢。8例患者中有7例结肠转运缓慢。其中5例的延迟影响整个结肠（“全结肠惰性”）；2例升结肠和横结肠的转运正常，但固体物质在左结肠移动缓慢。还使用不透X线标志物测量了平均结肠转运；如通过同步闪烁扫描测量全结肠转运所示，该技术识别出了转运缓慢的患者。然而，不透X线标志物技术估计的升结肠和横结肠转运时间明显较短。总之，特发性便秘的特征是升结肠和横结肠的储存功能亢进和/或降结肠推进功能受损。颗粒大小可能会影响结肠区域转运试验的结果。肠道其他部位的转运延迟表明，在一些患者中，该病症可能是一种更普遍的运动功能障碍。
