Department of Gastroenterology and Hepatology, Renmin Hospital of Wuhan University, Key Laboratory of Hubei Province for Digestive System Diseases, Wuhan, Hubei Province, China.
Farncombe Family Digestive Health Research Institute, McMaster University, Department of Medicine, Hamilton, ON, Canada.
Sci Rep. 2017 Feb 14;7:42293. doi: 10.1038/srep42293.
Manometry is used worldwide to assess motor function of the gastrointestinal tract, and the measured intraluminal pressure patterns are usually equated with contraction patterns. In the colon, simultaneous pressure increases throughout the entire colon are most often called simultaneous contractions, although this inference has never been verified. To evaluate the relationship between pressure and contraction in the colon we performed high-resolution manometry and measured diameter changes reflecting circular muscle contractions in the rabbit colon. We show that within a certain range of contraction amplitudes and frequencies, the intraluminal pressure pattern faithfully resembles the contraction pattern. However, when the frequency is very high (as in fast propagating contractions in a cluster) the consequent intraluminal pressures merge. When the contraction speed of propagation is very fast (above ~5 cm/s), the resulting pressure occurs simultaneous throughout the colon; hence simultaneous pressure is measured as are caused by fast propagating contractions. The very slow propagating, low amplitude haustral boundary contractions show a very characteristic pattern in spatiotemporal contraction maps that is not faithfully reproduced in the pressure maps. Correct interpretation of pressure events in high-resolution manometry is essential to make it a reliable tool for diagnosis and management of patients with colon motor dysfunction.
测压法被广泛用于评估胃肠道的运动功能,测量得到的腔内压力模式通常与收缩模式相对应。在结肠中,整个结肠同时出现压力升高的情况通常被称为同时收缩,尽管这一推断从未得到验证。为了评估结肠中压力与收缩之间的关系,我们进行了高分辨率测压,并测量了反映兔结肠环形肌收缩的直径变化。我们发现,在一定的收缩幅度和频率范围内,腔内压力模式忠实地反映了收缩模式。然而,当频率非常高时(如在簇状快速传播收缩中),随后的腔内压力会融合。当传播速度非常快时(超过~5 cm/s),产生的压力会同时出现在整个结肠中;因此,同时测量到的压力是由快速传播的收缩引起的。传播速度非常慢、幅度很低的分节边界收缩在时空收缩图中呈现出非常特征性的模式,而在压力图中则无法忠实地再现。正确解释高分辨率测压中的压力事件对于使其成为诊断和治疗结肠运动功能障碍患者的可靠工具至关重要。