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目的研究肠易激综合征(IBS)患者乙状结肠移行性运动与胃肠肽胆囊收缩素(CCK)、胃动素(MTL)的关系,探讨CCK、MTL对IBS患者乙状结肠动力的调节作用。方法对2004年3月至2005年2月,在广西壮族自治区人民医院消化内科住院,符合罗马Ⅱ诊断标准的腹泻型(D-IBS)和便秘型(C-IBS)IBS患者各20例及年龄、性别匹配的健康志愿者组15名(男7名、女8名),分别采用毛细管液体灌注测压法记录空腹状态下乙状结肠移行性高幅突发波的波幅及占记录时间百分比;同时采用放射免疫法测定所有研究对象血浆和乙状结肠黏膜CCK、MTL的含量。结果D-IBS组乙状结肠移行性高幅突发波的波幅和持续时间显著高于C-IBS组和健康组(P<0.05),D-IBS组血浆MTL、CCK浓度显著高于C-IBS组和健康组(P<0.01),黏膜MTL显著高于C-IBS组和健康组(P<0.01)。IBS患者乙状结肠移行高幅突发波的波幅和持续时间与血浆或黏膜CCK、MTL分别呈正相关(P<0.05)。结论IBS患者乙状结肠移行性运动可能受血浆CCK、黏膜和血浆MTL浓度相关的正性调节作用。
Objective To investigate the relationship between sigmoid colon transitional movement and gastrointestinal peptide cholecystokinin (CCK) and motilin (MTL) in patients with irritable bowel syndrome (IBS) and to explore the regulatory effect of CCK and MTL on sigmoid colon motility in patients with IBS. Methods From March 2004 to February 2005, 20 patients with diarrhea (D-IBS) and constipation (C-IBS) IBS hospitalized in Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region , And 15 healthy volunteers (7 males and 8 females) were matched by sex, and the amplitude of high-amplitude sudden wave of sigmoid colon transition and percentage of recording time under fasting state were recorded by capillary liquid perfusion manometry. At the same time, The contents of CCK and MTL in plasma and sigmoid colon mucosa were determined by radioimmunoassay. Results The amplitude and duration of high-amplitude sudden wave of sigmoid colon transition in D-IBS group were significantly higher than those in C-IBS group and healthy group (P <0.05). The plasma concentrations of MTL and CCK in D-IBS group were significantly higher than those in C-IBS group And healthy group (P <0.01). The MTL of mucosa was significantly higher than that of C-IBS group and healthy group (P <0.01). IBS patients with sigmoid colon high amplitude burst wave amplitude and duration and plasma or mucosal CCK, MTL were positively correlated (P <0.05). Conclusions The sigmoid colon transitional movement in IBS patients may be positively regulated by the concentration of plasma CCK, mucosa and plasma MTL.