Pinna Pintor M, Zara G P, Falletto E, Monge L, Demattei M, Carta Q, Masenti E
University of Turin, Italy.
Int J Colorectal Dis. 1994 May;9(2):105-9. doi: 10.1007/BF00699423.
To investigate the pathophysiology of faecal incontinence in diabetes mellitus, two groups of diabetic patients were studied: 14 subjects (7 females and 7 males, mean age 57 +/- 9 years) with faecal incontinence (Group A) and 15 subjects (6 females and 9 males, mean age 54.7 +/- 8 years) without faecal incontinence but affected by somatic peripheral neuropathy. A third group (C) of 10 healthy volunteers was used as controls. All subjects underwent electroneurographic evaluation of peripheral neuropathy, pudendal nerve terminal motor latency, anorectal manometry and rectal sensitivity tests. All the patients of group A had somatic peripheral neuropathy. Maximum squeeze pressure was lower in A compared to C (P < 0.025) and sustained for a shorter period in A compared with B (P < 0.0005) and C (P < 0.0005). All rectal sensitivity thresholds were higher in A compared with B and C. Pudendal Nerve Terminal Motor Latency was prolonged in 93% of patients studied in group A and in 73% of patients in group B (A vs B P < 0.005), with a significant difference in comparison with C: A vs C P < 0.0005, B vs C P < 0.005. Our findings suggest that somatic neuropathy plays an important role in faecal incontinence in diabetic patients, combined with sensation threshold impairment as a feature of an autonomic involvement.
为研究糖尿病患者大便失禁的病理生理学，对两组糖尿病患者进行了研究：14名有大便失禁的患者（7名女性和7名男性，平均年龄57±9岁）（A组）和15名无大便失禁但患有躯体周围神经病变的患者（6名女性和9名男性，平均年龄54.7±8岁）。第三组（C组）为10名健康志愿者作为对照。所有受试者均接受了周围神经病变的神经电图评估、阴部神经终末运动潜伏期、肛门直肠测压和直肠敏感性测试。A组所有患者均有躯体周围神经病变。与C组相比，A组的最大收缩压较低（P<0.025），与B组（P<0.0005）和C组（P<0.0005）相比，A组的最大收缩压持续时间较短。与B组和C组相比，A组所有直肠敏感性阈值均较高。A组93%的研究患者和B组73%的患者阴部神经终末运动潜伏期延长（A组与B组比较，P<0.005），与C组相比有显著差异：A组与C组比较，P<0.0005，B组与C组比较，P<0.005。我们的研究结果表明，躯体神经病变在糖尿病患者大便失禁中起重要作用，同时感觉阈值受损是自主神经受累的一个特征。
