Yik Yee Ian, Farmer Pamela J, King Sebastian K, Chow C W, Hutson John M, Southwell Bridget R
F Douglas Stephens Surgical Research Laboratory, Murdoch Childrens Research Institute, Melbourne, Australia.
Pediatr Surg Int. 2011 Jul;27(7):699-704. doi: 10.1007/s00383-011-2852-1. Epub 2011 Feb 2.
Adult slow-transit constipation (STC) occurs predominantly in females and is associated with low numbers of substance P (SP)-containing nerves in colonic circular muscle.
To determine if reduced SP nerves is female predominant in paediatric STC.
Children with STC were identified from records of more than 600 nuclear transit studies (NTS) and intestinal biopsies done for intractable chronic constipation between November 1998 and March 2009. Colonic seromuscular biopsies collected from hepatic and splenic flexures, and sigmoid colon were processed for immunohistochemistry. Nerve fibre density in circular muscle containing SP was measured qualitatively by a pathologist.
Eighty-eight children with chronic constipation had both NTS and intestinal biopsies. Seventy-eight children (52 M; age 2-15.5 years; mean 7.7 years) had STC diagnosed by NTS. SP was reduced in 10/26 girls, but only 11/52 boys.
In this sample, STC was more common in boys than girls. However, in girls with STC, SP deficiency occurred in 40%, when compared with 20% of boys. During puberty, the percentage of girls with reduced SP decreased, whilst the percentage of boys increased. These results suggest that STC is heterogeneous and that there are some gender differences, the implication of which requires further investigation.
成人慢传输型便秘（STC）主要发生于女性，且与结肠环行肌中含P物质（SP）的神经数量减少有关。
确定小儿STC中SP神经减少是否以女性为主。
从1998年11月至2009年3月间为顽固性慢性便秘进行的600多项核传输研究（NTS）记录和肠道活检记录中识别出患有STC的儿童。对从肝曲、脾曲和乙状结肠采集的结肠浆肌层活检组织进行免疫组织化学处理。由病理学家定性测量含SP的环行肌中的神经纤维密度。
88名患有慢性便秘的儿童同时进行了NTS和肠道活检。78名儿童（52名男性；年龄2至15.5岁；平均7.7岁）经NTS诊断为STC。10/26名女孩的SP减少，但男孩中只有11/52名。
在这个样本中，STC在男孩中比女孩中更常见。然而，在患有STC的女孩中，40%存在SP缺乏，而男孩中这一比例为20%。在青春期，SP减少的女孩比例下降，而男孩比例上升。这些结果表明STC是异质性的，并且存在一些性别差异，其意义需要进一步研究。
