Gorard D A, Libby G W, Farthing M J
Department of Gastroenterology, St Bartholomew's Hospital, London.
Gut. 1994 Feb;35(2):203-10. doi: 10.1136/gut.35.2.203.
Dysmotility of the duodenum and proximal jejunum has been reported in patients with irritable bowel syndrome. This study extended these findings by recording fasting ambulatory motility from electronic strain gauge sensors sited in the jejunum and ileum of eight diarrhoea predominant irritable bowel syndrome patients and 12 healthy controls. During the day, periodicity of migrating motor complexes mean (SEM) did not differ between patients (92 (10) min) and controls (85 (7) min). At night, periodicity was shorter in both patients and controls, and the daytime dominance of phase II was replaced by phase I. In both groups, aboral progression of phase III fronts was associated with a slowing of propagation velocity and maximum contractile rate, but an increase in mean amplitude of contraction. Discrete clustered contractions were seen in seven patients and 10 controls occupying 14 and 16% of daytime phase II activity, respectively. Pain episodes were not associated with any specific motility patterns. Despite the lack of motility differences between the two groups, orocaecal transit time in the irritable bowel syndrome patients was shorter at 57 (9) min than in the controls, 82 (6) min (p < 0.05). This ambulant study has failed to show any abnormalities of fasting small intestinal motility that might distinguish diarrhoea predominant irritable bowel syndrome patients from healthy controls.
肠易激综合征患者中已报告有十二指肠和空肠近端运动功能障碍。本研究通过记录8名腹泻型肠易激综合征患者和12名健康对照者空肠和回肠中电子应变计传感器的空腹动态运动，扩展了这些发现。白天，患者（92（10）分钟）和对照者（85（7）分钟）之间移行性运动复合波的周期性平均值（标准误）无差异。夜间，患者和对照者的周期性均缩短，且白天II期的优势被I期取代。在两组中，III期波峰的向肛推进与传播速度和最大收缩率减慢相关，但收缩平均幅度增加。在7名患者和10名对照者中观察到离散的成簇收缩，分别占白天II期活动的14%和16%。疼痛发作与任何特定的运动模式均无关联。尽管两组之间运动功能无差异，但肠易激综合征患者的口盲肠转运时间较短，为57（9）分钟，而对照者为82（6）分钟（p<0.05）。这项动态研究未能显示出任何可将腹泻型肠易激综合征患者与健康对照者区分开来的空腹小肠运动异常。
