Lee H J, Jung K W, Han S, Kim J W, Park S-K, Yoon I J, Koo H S, Seo S Y, Yang D-H, Kim K-J, Ye B D, Byeon J-S, Yang S-K, Kim J-H, Myung S-J
Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Neurogastroenterol Motil. 2014 Apr;26(4):529-37. doi: 10.1111/nmo.12297. Epub 2014 Jan 6.
High-resolution manometry (HRM) based on spatiotemporal plots is increasingly being used. The aim this study was to evaluate, for the first time, the influence of gender, with adjustment for age, body mass index (BMI), and vaginal delivery, on anorectal functions in asymptomatic adults.
Fifty-four asymptomatic healthy subjects (M : F = 27 : 27; age = 20-67 years) who were matched by age and gender were enrolled prospectively. We evaluated anorectal pressures, rectal sensation using a HRM probe, and balloon expulsion time. Multivariate linear regression analysis was performed to identify the independent effects of each factor.
Anal resting pressure (median [IQR]; 32 [18] vs 46 [17] mmHg, p < 0.001), anal squeeze pressure (75 [28] vs 178 [72] mmHg, p < 0.001), rectal pressure (33 [16] vs 53 [46] mmHg, p = 0.009) and anal pressure (16 [17] vs 30 [36] mmHg, p = 0.019) during simulated evacuation with rectal distention, and the threshold for the desire to defecate (60 [20] vs 80 [60] mL, p = 0.020) were significantly lower in women than in men. BMI was positively correlated with anal resting pressure (95% CI: 0.598-2.947) and negatively correlated with the threshold for first sensation (95% CI: -0.099 to -0.015). Vaginal delivery did not affect any of the anorectal HRM parameters.
CONCLUSIONS & INFERENCES: HRM parameters may be associated with gender and BMI. Therefore, gender and BMI should be taken into consideration when interpreting HRM results.
基于时空图的高分辨率测压法（HRM）的应用越来越广泛。本研究旨在首次评估在对年龄、体重指数（BMI）和阴道分娩进行校正后，性别对无症状成年人肛门直肠功能的影响。
前瞻性纳入54名年龄和性别匹配的无症状健康受试者（男∶女 = 27∶27；年龄20 - 67岁）。我们使用HRM探头评估肛门直肠压力、直肠感觉和球囊排出时间。进行多变量线性回归分析以确定各因素的独立作用。
在模拟直肠扩张排便期间，女性的肛门静息压力（中位数[四分位间距]；32[18] vs 46[17] mmHg，p < 0.001）、肛门收缩压力（75[28] vs 178[72] mmHg，p < 0.001）、直肠压力（33[16] vs 53[46] mmHg，p = 0.009）和肛门压力（16[17] vs 30[36] mmHg，p = 0.019）以及排便欲望阈值（60[20] vs 80[60] mL，p = 0.020）均显著低于男性。BMI与肛门静息压力呈正相关（95%CI：0.598 - 2.947），与首次感觉阈值呈负相关（95%CI： - 0.099至 - 0.015）。阴道分娩不影响任何肛门直肠HRM参数。
HRM参数可能与性别和BMI有关。因此，在解释HRM结果时应考虑性别和BMI。
