Twenty-four hour recordings of colonic motility in patients with diverticular disease - Evidence for abnormal motility and propulsive activity
Twenty-four hour recordings of colonic motility in patients with diverticular disease - Evidence for abnormal motility and propulsive activity
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DOI：
10.1007/bf02234460
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发表时间：
2001-12-01
影响因子：
3.9
通讯作者：
Tonini, M
中科院分区：
文献类型：
--
作者：
Bassotti, G;Battaglia, E;Tonini, M
简介：结肠憩室病是西方国家最常见的病理实体之一。尽管大肠蠕动的改变通常被认为是主要的病理生理机制之一，但尚未报道令人信服的证据。事实上，文献中只有少数关于远端结肠运动的相互矛盾的研究（没有关于强力推进活动的信息）。目的：本研究的目的是调查憩室病患者的横结肠（未受影响）、降结肠和乙状结肠的基础和刺激（餐后）结肠运动，并检测高振幅传播收缩（质量运动）。将患者的运动数据与健康对照受试者的运动数据进行比较。方法：本研究招募了 10 名患者和 16 名男女对照受试者。在所有受试者中，通过结肠镜定位的测压导管记录 24 小时内的结肠运动。研究期间提供两顿 1000 kcal 的混合餐。结果：与对照组相比，憩室病患者受影响节段的运动量显着增加；患者组对生理刺激（膳食）的反应也异常。与对照受试者相比，憩室病患者的强力推进活动也显着增加（患者平均 = 10.3 +/- 2.7/受试者/天高振幅传播收缩，对照受试者平均 = 5.5 +/- 0.8/受试者/天；P = 0.051）；有趣的是，大约 20% 的此类活动是异常的，以逆行方式传播。结论：我们得出结论，结肠憩室病患者的大肠运动和推进活动异常，仅限于受影响的节段。
INTRODUCTION: Diverticular disease of the colon is one of the most common pathologic entities in western countries. Although altered motility of the large bowel is commonly believed to be one of the major pathophysiologic mechanisms, no convincing evidence has been reported yet. In fact, only a few conflicting studies concerning distal colonic motility (with no information on forceful propulsive activity) are available in the literature. PURPOSE: The purpose of the present study was to investigate basal and stimulated (postprandial) colonic motility from the transverse (not affected), descending, and sigmoid colon in patients with diverticular disease, together with detection of high-amplitude propagated contractions (mass movements). Motility data from patients were compared with those obtained in healthy control subjects. METHODS: Ten patients and 16 control subjects of both sexes were recruited for the study. In all subjects, colonic motility was recorded for a 24-hour period by a colonoscopically positioned manometric catheter. Two 1000-kcal mixed meals were served during the study. RESULTS: Compared with control subjects, patients with diverticular disease displayed significantly increased amounts of motility in the affected segments; the response to a physiologic stimulus (meal) was also abnormal in the patients' group. Diverticular disease patients also had a significant increase of forceful propulsive activity compared with control subjects (average = 10.3 +/- 2.7/subject/day high-amplitude propagated contractions for patients and 5.5 +/- 0.8/subject/day for control subjects; P = 0.051); interestingly, about 20 percent of such activity was abnormal, being propagated in a retrograde fashion. CONCLUSIONS: We concluded that patients with diverticular disease of the colon have abnormal motor and propulsive activities of the large bowel, which are confined to the affected segments.