Khuroo M S, Zargar S A, Yattoo G N, Allai M S, Khan B A, Dar M Y, Boda M I, Javid G
Department of Gastroenterology, Institute of Medical Sciences, Srinagar, India.
Hepatology. 1993 Jan;17(1):53-8.
Oddi's sphincter motor activity was studied in 15 healthy subjects and 15 patients with recurrent pyogenic cholangitis. No significant difference was found in the common bile duct pressures, the Oddi's sphincter basal pressures or the amplitude, frequency and duration of phasic contractions between the controls and patients. However, a significant difference was found in the percentage of antegrade and retrograde phasic wave sequences between the two groups. In control patients 64.0% +/- 5.3% of phasic wave sequences were antegrade, and 20% +/- 3.6% were retrograde. In patients with recurrent pyogenic cholangitis, 37% +/- 3.6% of phasic wave sequences were antegrade, and 42% +/- 5.5% were retrograde. No significant difference was found in the percentage of simultaneous phasic wave sequences (16% +/- 1.5% vs. 18.5% +/- 2.8%, respectively) between the two groups. In all, five (33%) patients with recurrent pyogenic cholangitis had abnormal propagation of phasic contractions of Oddi's sphincter (retrograde phasic wave sequences greater than 50%), two (13%) patients had elevated Oddi's sphincter basal pressures (greater than 40 mm Hg) and one (7%) patient had increased frequency of Oddi's sphincter phasic contractions (more than 9/min). Six of the 15 patients had evidence of papillitis on duodenoscopy. We believe papillitis could induce motor abnormalities in these patients, thus resulting in delayed biliary drainage and recurrent attacks of cholangitis.
对15名健康受试者和15名复发性化脓性胆管炎患者的奥迪括约肌运动活性进行了研究。对照组和患者之间在胆总管压力、奥迪括约肌基础压力或相性收缩的幅度、频率和持续时间方面未发现显著差异。然而，两组之间顺行和逆行相性波序列的百分比存在显著差异。在对照患者中，64.0%±5.3%的相性波序列是顺行的，20%±3.6%是逆行的。在复发性化脓性胆管炎患者中，37%±3.6%的相性波序列是顺行的，42%±5.5%是逆行的。两组之间同时相性波序列的百分比（分别为16%±1.5%和18.5%±2.8%）未发现显著差异。总体而言，5名（33%）复发性化脓性胆管炎患者存在奥迪括约肌相性收缩的异常传播（逆行相性波序列大于50%），2名（13%）患者的奥迪括约肌基础压力升高（大于40 mmHg），1名（7%）患者的奥迪括约肌相性收缩频率增加（超过9次/分钟）。15名患者中有6名在十二指肠镜检查时有乳头炎的证据。我们认为乳头炎可能导致这些患者的运动异常，从而导致胆汁引流延迟和胆管炎反复发作。
