Bazzocchi G, Ellis J, Villanueva-Meyer J, Jing J, Reddy S N, Mena I, Snape W J
Department of Medicine, Harbor-University of California, Los Angeles Medical Center.
Gastroenterology. 1990 Mar;98(3):686-93. doi: 10.1016/0016-5085(90)90289-d.
The aim of this study was to correlate colonic motility and transit in patients with constipation and symptoms of the irritable bowel syndrome. Studies were performed in 16 patients with constipation and compared with the results in 12 healthy subjects. Intraluminal pressure was measured with perfused catheter ports in the transverse colon, splenic flexure, and descending and sigmoid colon. Movement of the luminal contents was measured by following the movement of Technetium-99m-DTPA that was instilled as a bolus in the splenic flexure. In both healthy subjects and patients with constipation there was no movement of the intraluminal tracer and no increase in intraluminal pressure during fasting. After eating a meal, healthy subjects and one group of the constipated patients had an increase in the radioactive marker in the transverse colon (p less than 0.03) and in the sigmoid colon (p less than 0.03). The movement of the intraluminal contents was associated with a positive pressure gradient between the descending colon and the transverse and sigmoid colon. There was no retrograde movement of the intraluminal contents and no postprandial increase in intraluminal pressure in the second group of patients with constipation. In healthy subjects, propagating contractions, which were associated with the rapid movement of intraluminal contents, began 60 min after eating. There were no propagating contractions in patients with constipation. These studies suggest that (a) the movement of intraluminal contents in healthy and constipated patients is determined by the postprandial pressure gradients within the colon, and (b) the propagating contraction is necessary for a normal bowel habit.
本研究旨在关联便秘及肠易激综合征患者的结肠动力与转运情况。对16例便秘患者进行了研究，并与12名健康受试者的结果进行比较。通过在横结肠、脾曲、降结肠和乙状结肠中使用灌注导管端口测量腔内压力。通过追踪注入脾曲的锝-99m-二乙三胺五乙酸（Technetium-99m-DTPA）的运动来测量腔内内容物的移动。在健康受试者和便秘患者中，空腹时腔内示踪剂均无移动，腔内压力也无升高。进食后，健康受试者和一组便秘患者的横结肠（p<0.03）和乙状结肠（p<0.03）中的放射性标记物增加。腔内内容物的移动与降结肠与横结肠和乙状结肠之间的正压力梯度相关。第二组便秘患者的腔内内容物无逆行移动，餐后腔内压力也无升高。在健康受试者中，与腔内内容物快速移动相关的推进性收缩在进食后60分钟开始。便秘患者无推进性收缩。这些研究表明：（a）健康和便秘患者腔内内容物的移动由结肠内的餐后压力梯度决定；（b）推进性收缩对于正常排便习惯是必要的。
