TOWARDS A RELATIVELY INEXPENSIVE, NONINVASIVE, ACCURATE TEST FOR COLONIC MOTILITY DISORDERS
TOWARDS A RELATIVELY INEXPENSIVE, NONINVASIVE, ACCURATE TEST FOR COLONIC MOTILITY DISORDERS
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DOI：
10.1016/0016-5085(92)91092-i
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发表时间：
1992-07-01
期刊：
影响因子：
29.4
通讯作者：
ZINSMEISTER, AR
中科院分区：
文献类型：
--
作者：
CAMILLERI, M;ZINSMEISTER, AR
目前可用的结肠传输的临床试验，如不透射线标记方法，是有用的检测延迟传输，但可能不太敏感的快速传输。本研究的目的是开发一种相对便宜的，非侵入性的，准确的结肠运输试验，使用选定的结肠造影观察后的第一个24小时内摄入的pH敏感，甲基丙烯酸酯涂层，延迟释放胶囊含有111 In标记的树脂丸。分析了作者先前发表的22例健康受试者、9例以腹泻为主的肠易激综合征患者和7例特发性便秘患者的结肠运输数据以及先前未发表的4例类癌性腹泻患者的数据。使用逻辑判别分析来估计所选组合或转运简单总结的敏感性和特异性。在联合转运总结中，健康组和便秘组的近端结肠排空率存在显著差异;腹泻组4小时结肠同位素几何中心显著大于健康对照组;便秘组24小时几何中心显著低于其他两组。从逻辑判别分析，运输的简单总结也有显着的判别价值，这些包括同位素含量在升，横，降结肠在4小时和计数在升，横结肠和粪便在24小时。在90%的灵敏度下，4小时时横结肠计数的特异性为79%，这与近端结肠排空率的特异性相同，两者都根据年龄进行了调整。因此，在4小时和24小时进行的扫描上的结肠区域中的同位素计数的定量提供了结肠运输的准确总结，在检测结肠运动障碍的高灵敏度下具有可接受的特异性。
Currently available clinical tests of colonic transit, such as the radiopaque marker method, are useful to detect delayed transit but may be less sensitive for rapid transit. The aim of this study was to develop a relatively inexpensive, noninvasive, accurate test of colonic transit using selected scintigraphic observations within the first 24 hours after ingestion of a pH-sensitive, methacrylate-coated, delayed-release capsule containing111In-labeled resin pellets. The authors' previously published colonic transit data on 22 healthy subjects, 9 patients with diarrhea-predominant irritable bowel syndrome, and 7 patients with idiopathic constipation and previously unpublished data on 4 patients with carcinoid diarrhea were analyzed. A logistic discriminant analysis was used to estimate the sensitivity and specificity of selected combinations or simple summaries of transit. Among combined transit summaries, the emptying rate of the proximal colon was significantly different between healthy and constipation groups; the geometric center of isotope in the colon at 4 hours was significantly greater in the diarrhea group than in healthy controls; the geometric center at 24 hours was significantly lower in the constipation group than in the other two groups. From the logistic discriminant analysis, simple summaries of transit also had significant discriminant value; these included the isotopic contents in the ascending, transverse, and descending colon at 4 hours and the counts in the ascending and transverse colon and stool at 24 hours. At 90% sensitivity, the specificity of the transverse colon counts at 4 hours was 79%, which is identical to the specificity of the proximal colon emptying rate, both adjusted for age. Thus, quantitation of isotopic counts in colonic regions on scans taken at 4 and 24 hours provides an accurate summary of colonic transit, with acceptable specificity at a high sensitivity in the detection of motility disorders of the colon.