ALTERED RECTAL PERCEPTION IS A BIOLOGICAL MARKER OF PATIENTS WITH IRRITABLE-BOWEL-SYNDROME
ALTERED RECTAL PERCEPTION IS A BIOLOGICAL MARKER OF PATIENTS WITH IRRITABLE-BOWEL-SYNDROME
复制标题
DOI：
10.1016/0016-5085(95)90267-8
复制
发表时间：
1995-07-01
期刊：
影响因子：
29.4
通讯作者：
MAYER, EA
中科院分区：
文献类型：
--
作者：
MERTZ, H;NALIBOFF, B;MAYER, EA
背景和目的：内脏知觉阈值降低被认为是肠易激综合征（IBS）的生物学标志。本研究旨在确定 IBS 患者直肠内脏知觉改变的患病率以及知觉阈值改变与主观症状的相关性。方法：确定 100 名 IBS 患者和 15 名对照受试者的肛门直肠测压和直肠感知阈值。通过问卷调查评估胃肠道和心理症状。 3 个月后，对 15 名 IBS 患者的感知阈值和症状进行了重新评估。结果：94% 的患者表现出直肠知觉改变，表现为厌恶感觉（不适）阈值降低、感觉强度增加或内脏转介改变。超敏反应仅针对快速阶段性扩张所产生的厌恶感；大便阈值和对缓慢斜坡扩张的响应阈值均正常。通过生理参数进行聚类分析，确定了具有主要症状模式的三个 IBS 亚组。纵向评估表明感知阈值的变化与症状严重程度之间存在相关性。结论：由于几乎所有 IBS 患者都存在直肠知觉改变，并且知觉阈值与回顾性症状严重程度的时间变化相关，因此直肠知觉改变代表了 IBS 的可靠生物学标志。
Background and Aims: Lowered visceral perception thresholds have been suggested as a biological marker of irritable bowel syndrome (IBS). The current study sought to determine the prevalence of altered rectal visceral perception in patients with IBS and the correlation of altered perception thresholds with subjective symptoms. Methods: Anorectal manometry and rectal perception thresholds to balloon distention were determined in 100 patients with IBS and 15 control subjects. Gastrointestinal and psychological symptoms were assessed by questionnaire. Perception thresholds and symptoms were reassessed after 3 months in 15 patients with IBS. Results: Ninety-four percent of patients showed altered rectal perception in the form of lowered thresholds for aversive sensations (discomfort), increased intensity of sensations, or altered viscerosomatic referral. Hypersensitivity was found only for aversive sensations in response to rapid phasic distention; stool thresholds and thresholds in response to slow ramp distention were normal. Cluster analysis by physiological parameters identified three IBS subgroups with predominant patterns of symptoms. Longitudinal evaluation indicated a correlation between changes in perception thresholds and symptom severity. Conclusions: Because altered rectal perception is present in almost all patients with IBS and perception thresholds correlate with temporal changes in retrospective symptom severity, altered rectal perception represents a reliable biological marker of IBS.