Loening-Baucke V, Metcalf A M, Shirazi S
Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City.
Am J Gastroenterol. 1989 Aug;84(8):892-7.
Anorectal function was measured in 11 patients with active medically intractable ulcerative colitis, seven patients with quiescent ulcerative colitis, and 18 healthy subjects. The anal resting pressure, squeeze pressure, and ability to defecate a balloon were similar in all groups. Significantly lower rectal distention volumes were required for rectal sensation, critical volume, and to induce rectal contractility in patients with active disease compared to controls or patients with quiescent disease. Rectal compliance was significantly reduced in patients with active and quiescent disease. The increased rectal sensitivity and contractility in patients with active colitis appear to be related to active mucosal inflammation and ulceration. Episodes of mucosal inflammation may be responsible for chronic changes in the rectal wall resulting in fibrosis and decreased compliance in patients with quiescent disease. The frequency and urgency of defecation and the fecal incontinence may be due to a hypersensitive, hyperactive, and poorly compliant rectum.
对11例药物治疗无效的活动性溃疡性结肠炎患者、7例静止期溃疡性结肠炎患者和18名健康受试者进行了肛肠功能测量。所有组的肛门静息压、挤压压和排出气囊的能力相似。与对照组或静止期疾病患者相比，活动性疾病患者产生直肠感觉、临界容量和诱导直肠收缩所需的直肠扩张体积显著更低。活动性和静止期疾病患者的直肠顺应性均显著降低。活动性结肠炎患者直肠敏感性和收缩性增加似乎与活动性黏膜炎症和溃疡有关。黏膜炎症发作可能是静止期疾病患者直肠壁发生慢性变化导致纤维化和顺应性降低的原因。排便频率、急迫感和大便失禁可能归因于直肠过敏、活跃及顺应性差。
