Yildirim A E, Korkmaz M, Altun R, Sandikçi S C, Ocal S, Selçuk H
Department of Gastroenterology, Department of Internal Medicine, Başkent University, Faculty of Medicine, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2016 Apr;20(7):1315-22.
Irritable bowel syndrome (IBS) is a common functional intestinal disorder. Although there are marked improvements in the conceptualization of IBS pathophysiology in brain-intestinal interaction disorder, there is no definite consensus in the role of autonomic dysfunction (AD) in disease development and symptom progression. The aim of this study was to evaluate autonomous dysfunction in IBS subgroups.
A total of 50 patients and 49 healthy controls were included. IBS subgroup types and demographic characteristics of patients were recorded. AD investigations were made up of parasympathetic and sympathetic tests.
There was no statistically significant difference was determined between the groups in accordance to demographic characteristics such as age, gender, BMI and resting heart rate (p > 0.05). Three parasympathetic and one sympathetic autonomic neuropathy tests were found significantly different (respectively p < 0.001, p = 0.001, p = 0.016, p < 0.001, p = 0.375). There were significant decreases in parasympathetic tests in IBS-C patients; however, in the control group, there were significant decreases in sympathetic tests when compared with IBS-D patients (p < 0.001). The severity of AD in IBS-C subgroup was more pronounced than the IBS-D subgroup. No correlation was determined between dysautonomia and disease duration (p > 0.05).
AD may have a role in IBS pathophysiology. Deterioration of the autonomous system not only affects the gastrointestinal system but also other systems including the cardiovascular system. Patients may also be susceptible to more diverse problems.
肠易激综合征(IBS)是一种常见的功能性肠道疾病。尽管在脑-肠互动障碍中IBS病理生理学的概念化有了显著进展,但自主神经功能障碍(AD)在疾病发展和症状进展中的作用尚无明确共识。本研究的目的是评估IBS亚组中的自主神经功能障碍。
共纳入50例患者和49例健康对照。记录患者的IBS亚组类型和人口统计学特征。AD检查包括副交感神经和交感神经测试。
根据年龄、性别、BMI和静息心率等人口统计学特征,两组之间未发现统计学上的显著差异(p>0.05)。发现三项副交感神经和一项交感神经自主神经病变测试有显著差异(分别为p<0.001、p=0.001、p=0.016、p<0.001、p=0.375)。IBS-C患者的副交感神经测试有显著下降;然而,与IBS-D患者相比,对照组的交感神经测试有显著下降(p<0.001)。IBS-C亚组中AD的严重程度比IBS-D亚组更明显。未发现自主神经功能障碍与疾病持续时间之间存在相关性(p>0.05)。
AD可能在IBS病理生理学中起作用。自主神经系统的恶化不仅影响胃肠道系统,还影响包括心血管系统在内的其他系统。患者可能也更容易出现更多样化的问题。