Madrid A M, Brahm J, Antezana C, González-Koch A, Defilippi C, Pimentel C, Oksenberg D, Defilippi C
Department of Medicine, University Hospital, University of Chile, Santiago.
Am J Gastroenterol. 1998 Dec;93(12):2436-40. doi: 10.1111/j.1572-0241.1998.00700.x.
Previous studies have shown small bowel motor activity abnormalities in patients with liver cirrhosis of different etiologies, but motility has not been studied in patients with primary biliary cirrhosis. Our aim was to investigate proximal small bowel motility in these patients.
Twenty-five female patients presenting clinical, biochemical, serological, and histological findings compatible with primary biliary cirrhosis, 10 female patients with nonalcoholic liver cirrhosis, and 10 normal female controls were studied. Motility of the upper small bowel was measured in the fasted state by means of perfused manometric catheters, connected to external transducers and positioned in the small bowel under fluoroscopy.
The average amplitude of contractions was significantly decreased in patients with primary biliary cirrhosis compared with other liver cirrhosis (20.2+/-1.0 vs 32+/-2.9 mm Hg). Also, a significantly increased frequency of cluster of contractions and an increased duration of phase II of the migrating motor complex as seen in liver cirrhosis was observed when compared with normals.
We conclude that primary biliary cirrhosis patients present motor abnormalities of the small intestine similar to those of patients with liver cirrhosis of other etiologies. In addition, a decrease in the amplitude of small bowel contractions was also found in these patients, suggesting a myogenic involvement.
既往研究显示,不同病因的肝硬化患者存在小肠运动活动异常,但原发性胆汁性肝硬化患者的运动情况尚未得到研究。我们的目的是调查这些患者的近端小肠运动情况。
对25例具有符合原发性胆汁性肝硬化的临床、生化、血清学及组织学表现的女性患者、10例非酒精性肝硬化女性患者及10例正常女性对照者进行研究。在禁食状态下,通过与外部换能器相连并在荧光镜引导下置于小肠内的灌注测压导管测量上段小肠的运动情况。
与其他肝硬化患者相比,原发性胆汁性肝硬化患者的平均收缩幅度显著降低(20.2±1.0 vs 32±2.9 mmHg)。此外,与正常人相比,原发性胆汁性肝硬化患者可见收缩簇频率显著增加,且移行性运动复合波II期持续时间延长,这与肝硬化患者的情况相似。
我们得出结论,原发性胆汁性肝硬化患者存在与其他病因肝硬化患者相似的小肠运动异常。此外,这些患者还存在小肠收缩幅度降低的情况,提示存在肌源性因素参与。