【摘要】 目的:通过对不同类型功能性便秘(FC)患者肛门直肠动力和感觉功能的研究,比较不同类型FC患者病理生理机制上的异同。方法:根据结肠转运时间(CTT)和传输指数(TI)对FC患者进行分型,分为传输时间正常型(NTC)、慢传输型(STC)、出口梗阻型(OOC)和混合型(MC);用肛门直肠测压的方法测定不同类型FC患者的肛门直肠动力及感觉功能,同时选择健康人作对照组。结果:与健康对照组相比,FC患者肛管静息压降低,排便感觉阈值和最大耐受容量均增高(P<0.01);各型FC患者肛管静息压均降低(P<0.01);NTC组和OOC组排便感觉阈值和最大耐受容量增高(P<0.01);STC组引起直肠肛门抑制反射的最低容量(MRV)降低,初始感觉阈值降低、排便感觉阈值增高(P<0.05);各组间肛管静息压、缩榨压、排便感觉阈值比较均未见明显异常。结论:肛门直肠动力和感觉功能异常,是FC患者发病的一个重要的病理生理机制。NTC患者和OOC患者在动力和感觉功能上表现出一定的共性,推断其病理生理机制可能存在一定的联系。STC患者的发病是多因素造成的动力紊乱。更多还原

【Abstract】 Objective:To investigate the differences of the anorectal motility and perception among functional constipation subtypes. Methods:Functional constipation was categorized according to colon transit time(CTT) and transit index(TI). Four types were divided: normal transit constipation(NTC),slow transit constipation(STC),outlet obstructive constipation(OOC),and mixed type constipation (MC). Anorectal manometry was carried out in all subjects to investigate the anorectal motility and sensory function in patients and the controls. Results:Compared with controls,(1)anal resting pressure in FC patients was significantly higher,while the defecation thresholds and the pressure of urgency were much lower.(2)All subtypes of FC displayed significantly lower anal resting pressure;The defecation thresholds and the pressure of urgency of NTC and OOC were significantly increased ,while STC displayed lower minimum relaxation volume,first sensation,and higher defecation thresholds;No significant difference among four subtypes. Conclusion: (1) Abnormality of anorectal motility and perception is an important pathogenesis of FC;(2)According to the similarity among different groups,there might be some connection in pathomechanism between NTC and OOC;(3)The pathogenesis of STC is complicated. Lots of motility factors should be contributed to its pathogenesis.更多还原