Rao S S, Read N W, Davison P A, Bannister J J, Holdsworth C D
Sub-Department of Human Gastrointestinal Physiology and Nutrition, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Gastroenterology. 1987 Dec;93(6):1270-5. doi: 10.1016/0016-5085(87)90255-1.
Anorectal function in ulcerative colitis was assessed by measuring pressures at multiple sites in the anus and rectum under basal conditions and during balloon distention of the rectum in 29 patients with ulcerative colitis (12 active, 11 quiescent, and 6 during both phases) and in 12 normal controls. Resting and squeeze sphincter pressures were similar in the three groups. The lowest rectal volume that could be perceived, the volume required to induce a desire to defecate, and the maximum tolerable rectal volume were all lower in patients with active colitis than in patients with quiescent colitis (p less than 0.001) and controls (p less than 0.001). The rectal volume required to cause a sustained anal relaxation was lower in patients with active colitis (p less than 0.05) than in controls. Both peak and steady state rectal pressures in response to rectal distention were significantly higher in patients with active colitis than in patients with quiescent colitis (p less than 0.05) and controls (p less than 0.02). Paired studies showed that during remission of disease there was a decrease in rectal sensitivity (p less than 0.05) and an increase in rectal compliance (p less than 0.05). These results suggest that the frequent and urgent defecation, i.e., the predominant feature of active colitis, is related to a hypersensitive and poorly compliant rectum, which, upon distention, is more reactive and is more likely to induce prolonged sphincter relaxation.
通过在基础状态下以及直肠气囊扩张期间测量29例溃疡性结肠炎患者（12例活动期、11例静止期和6例处于两个阶段）及12名正常对照者肛门和直肠多个部位的压力，评估溃疡性结肠炎患者的肛肠功能。三组患者的静息和挤压时的括约肌压力相似。活动期结肠炎患者能感觉到的最低直肠容量、引起排便欲望所需的容量以及最大可耐受直肠容量均低于静止期结肠炎患者（p<0.001）和对照组（p<0.001）。活动期结肠炎患者引起持续性肛门松弛所需的直肠容量低于对照组（p<0.05）。活动期结肠炎患者对直肠扩张的反应中，直肠压力的峰值和稳态均显著高于静止期结肠炎患者（p<0.05）和对照组（p<0.02）。配对研究表明，疾病缓解期直肠敏感性降低（p<0.05），直肠顺应性增加（p<0.05）。这些结果表明，频繁和急迫排便，即活动期结肠炎的主要特征，与直肠超敏和顺应性差有关，直肠扩张时反应更强，更易引起括约肌长时间松弛。
