Phenotypic variation of colonic motor functions in chronic constipation.
Phenotypic variation of colonic motor functions in chronic constipation.
复制标题
慢性便秘中结肠运动功能的表型变异。
DOI：
10.1053/j.gastro.2009.07.057
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发表时间：
2010
期刊：
影响因子：
29.4
通讯作者：
Zinsmeister,AlanR
中科院分区：
文献类型：
--
作者：
Ravi,Karthik;Bharucha,AdilE;Camilleri,Michael;Rhoten,Deborah;Bakken,Timothy;Zinsmeister,AlanR
背景与目的慢性便秘(CC)患者的结肠运动障碍是异质性的且不完全了解；结肠运输与运动活动之间的关系尚不清楚。我们试图描述慢性便秘的表型变异性。方法通过恒压测压装置对35名健康女性和111名CC患者的空腹和餐后结肠张力、时相活动度和压力-容量关系进行评估，这些患者包括结肠传输正常(NTC；n=25)、传输缓慢(STC；19)和排便障碍(DD-Normal；n=34)或传输缓慢(DD-Slow；n=33)的CC患者。Logistic回归模型评估了运动参数是否可以区分这些组。结果与健康受试者第10百分位数相比，NTC组空腹和/或餐后结肠张力和/或顺应性降低40%，STC组减少47%，DD正常组减少53%，DD慢传输组减少42%。与健康受试者相比，单纯STC和DD患者的依从性降低(P≤.05)，而NTC患者的依从性无明显变化。4个主成分解释了患者总变异的85%：因子1和因子2分别由空腹和餐后结肠时相活动和紧张度加权，因子3由餐后高幅度收缩和餐后紧张性反应加权，因子4由餐后紧张性反应决定。结论即使在NTC患者中，空腹和/或餐后结肠张力降低，反映运动功能障碍。结肠运动评估可以将慢性便秘定性为表型。还需要进一步的研究来评估这些表型、肠道神经病理和CC的治疗反应之间的关系。
BACKGROUND & AIMSColonic motor disturbances in chronic constipation (CC) are heterogeneous and incompletely understood; the relationship between colonic transit and motor activity is unclear. We sought to characterize the phenotypic variability in chronic constipation.METHODSFasting and postprandial colonic tone and phasic activity and pressure-volume relationships were assessed by a barostat manometric assembly in 35 healthy women and 111 women with CC who had normal colon transit (NTC; n = 25), slow transit (STC; n = 19), and defecatory disorders with normal (DD-normal; n = 34) or slow transit (DD-slow; n = 33). Logistic regression models assessed whether motor parameters could discriminate among these groups. Among CC, phenotypes were characterized by principal components analysis of these measurements.RESULTSCompared with 10th percentile values in healthy subjects, fasting and/or postprandial colonic tone and/or compliance were reduced in 40% with NTC, 47% with STC, 53% with DD-normal, and 42% with DD-slow transit. Compared with healthy subjects, compliance was reduced (P ≤ .05) in isolated STC and DD but not in NTC. Four principal components accounted for 85% of the total variation among patients: factors 1 and 2 were predominantly weighted by fasting and postprandial colonic phasic activity and tone, respectively; factor 3 by postprandial high-amplitude propagated contractions; and factor 4 by postprandial tonic response.CONCLUSIONSFasting and/or postprandial colonic tone are reduced, reflecting motor dysfunctions, even in NTC. Colonic motor assessments allow chronic constipation to be characterized into phenotypes. Further studies are needed to evaluate the relationship among these phenotypes, enteric neuropathology, and response to treatment in CC.
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影响因子：
9.8
作者：
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作者：
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通讯作者：
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DOI：
10.1007/978-88-470-1405-3_42
发表时间：
2012
期刊：
--
影响因子：
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作者：
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通讯作者：
Arieh Riskin;Carlo Agostoni;R. Shamir