SCINTIGRAPHIC MEASUREMENT OF REGIONAL GUT TRANSIT IN IDIOPATHIC CONSTIPATION
SCINTIGRAPHIC MEASUREMENT OF REGIONAL GUT TRANSIT IN IDIOPATHIC CONSTIPATION
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DOI：
10.1016/0016-5085(91)90466-x
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发表时间：
1991-07-01
期刊：
影响因子：
29.4
通讯作者：
PHILLIPS, S
中科院分区：
文献类型：
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作者：
STIVLAND, T;CAMILLERI, M;PHILLIPS, S
在这项研究中，总肠道传输和局部结肠传输的特发性便秘患者进行了测量。研究了8名患有严重便秘的患者，他们中没有一人具有骨盆底功能异常的证据。99 mTc-放射性标记的Amberlite树脂颗粒（平均直径，1 mm; Sigma Chemical Co.，St. Louis，MO）与混合餐一起用于评估胃排空和小肠传输;在分散在回盲部区域的包衣胶囊中摄入用111 In标记的类似颗粒。这些用于量化结肠转运。还研究了5名健康志愿者。2例患者表现为胃排空延迟，2例小肠传输缓慢。8例患者中有7例结肠传输缓慢。在5例中，延迟影响整个结肠（“全结肠惯性”）;在2例中，升结肠和横结肠的传输是正常的，但固体通过左结肠缓慢。还使用不透射线的标记物测量平均结肠传输;该技术确定了传输缓慢的患者，如通过同步结肠造影测量的整体结肠传输所示。然而，通过不透射线标记技术估计的通过升结肠和横结肠的时间明显较短。总之，特发性便秘的特征是升结肠和横结肠的储气功能增强和/或降结肠推进功能受损。颗粒大小可能会影响区域结肠运输试验的结果。肠道其他部位的转运延迟表明，在某些患者中，这种情况可能是更广泛的运动功能障碍。
In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor.99mTc-radiolabeled Amberlite resin particles (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO) with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (“pancolonic inertia”); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. Transit delays in other parts of the gut suggest that, in some patients, the condition may be a more generalized motor dysfunction.