Lin Anthony Y, Du Peng, Dinning Philip G, Arkwright John W, Kamp Jozef P, Cheng Leo K, Bissett Ian P, O'Grady Gregory
Department of Surgery, University of Auckland, Auckland, New Zealand.
Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Am J Physiol Gastrointest Liver Physiol. 2017 May 1;312(5):G508-G515. doi: 10.1152/ajpgi.00021.2017. Epub 2017 Mar 23.
Colonic cyclic motor patterns (CMPs) have been hypothesized to act as a brake to limit rectal filling. However, the spatiotemporal profile of CMPs, including anatomic origins and distributions, remains unclear. This study characterized colonic CMPs using high-resolution (HR) manometry (72 sensors, 1-cm resolution) and their relationship with proximal antegrade propagating events. Nine healthy volunteers were recruited. Recordings were performed over 4 h, with a 700-kcal meal given after 2 h. Propagating events were visually identified and analyzed by pattern, origin, amplitude, extent of propagation, velocity, and duration. Manometric data were normalized using anatomic landmarks identified on abdominal radiographs. These were mapped over a three-dimensional anatomic model. CMPs comprised a majority of detected propagating events. Most occurred postprandially and were retrograde propagating events (84.9 ± 26.0 retrograde vs. 14.3 ± 11.8 antegrade events/2 h, = 0.004). The dominant sites of initiation for retrograde CMPs were in the rectosigmoid region, with patterns proximally propagating by a mean distance of 12.4 ± 0.3 cm. There were significant differences in the characteristics of CMPs depending on the direction of travel and site of initiation. Association analysis showed that proximal antegrade propagating events occurred independently of CMPs. This study accurately characterized CMPs with anatomic correlation. CMPs were unlikely to be triggered by proximal antegrade propagating events in our study context. However, the distal origin and prominence of retrograde CMPs could still act as a mechanism to limit rectal filling and support the theory of a "rectosigmoid brake." Retrograde cyclic motor patterns (CMPs) are the dominant motor patterns in a healthy prepared human colon. The major sites of initiation are in the rectosigmoid region, with retrograde propagation, supporting the idea of a "rectosigmoid brake." A significant increase in the number of CMPs is seen after a meal. In our study context, the majority of CMPs occurred independent of proximal propagating events, suggesting that CMPs are primarily controlled by external innervation.
结肠周期性运动模式（CMPs）被认为起到限制直肠充盈的制动作用。然而，CMPs的时空特征，包括解剖学起源和分布，仍不清楚。本研究使用高分辨率（HR）测压法（72个传感器，1厘米分辨率）对结肠CMPs进行了特征描述，并研究了它们与近端顺行传播事件的关系。招募了9名健康志愿者。记录时长为4小时，2小时后给予一顿700千卡的餐食。通过模式、起源、幅度、传播范围、速度和持续时间对传播事件进行视觉识别和分析。使用腹部X光片上确定的解剖标志对测压数据进行标准化。将这些数据映射到三维解剖模型上。CMPs构成了大多数检测到的传播事件。大多数发生在餐后，且为逆行传播事件（每2小时84.9±26.0次逆行事件与14.3±11.8次顺行事件，P = 0.004）。逆行CMPs的主要起始部位在直肠乙状结肠区域，模式向近端传播的平均距离为12.4±0.3厘米。根据传播方向和起始部位的不同，CMPs的特征存在显著差异。关联分析表明，近端顺行传播事件独立于CMPs发生。本研究准确地描述了具有解剖学相关性的CMPs。在我们的研究背景下，CMPs不太可能由近端顺行传播事件触发。然而，逆行CMPs的远端起源和突出仍可作为限制直肠充盈的一种机制，并支持“直肠乙状结肠制动”理论。逆行性结肠周期性运动模式（CMPs）是健康准备状态下人体结肠中的主要运动模式。主要起始部位在直肠乙状结肠区域，呈逆行传播，支持“直肠乙状结肠制动”的观点。餐后CMPs的数量显著增加。在我们的研究背景下，大多数CMPs独立于近端传播事件发生，这表明CMPs主要受外部神经支配。
