Rectal distention testing in patients with irritable bowel syndrome:: Sensitivity, specificity, and predictive values of pain sensory thresholds
Rectal distention testing in patients with irritable bowel syndrome:: Sensitivity, specificity, and predictive values of pain sensory thresholds
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DOI：
10.1053/gast.2002.33601
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发表时间：
2002-06-01
期刊：
影响因子：
29.4
通讯作者：
Poitras, P
中科院分区：
文献类型：
--
作者：
Bouin, M;Plourde, V;Poitras, P
背景和目标：内脏超敏反应在功能性胃肠道疾病患者中被检测到，并已被提议作为肠易激综合征（IBS）的生物学标志物。本研究的目的是评估敏感性，特异性，和直肠扩张评价的疼痛阈值的预测值，使用电子恒压器在患者或没有IBS和对照组。方法：按罗马II标准诊断。直肠感觉阈值测定：164例患者（86例IBS患者，26例无痛性便秘，2：1功能性消化不良和31例其他条件）和25例正常对照。所有受试者都接受了一系列的直肠等压扩张使用电子恒压器。袋从0至48 mm Hg逐渐膨胀，作为对膨胀的反应，受试者报告不适或疼痛。结果如下：IBS患者的疼痛阈值（30.4 ± 6.7 mm Hg）低于对照组（44.5 ± 5）、无痛性便秘患者（45.4 ± 5.3）、功能性消化不良患者（39.4 ± 7.8）和其他患者（43.2 ± 5.5）。在40 mm Hg水平下，直肠恒压器鉴别IBS患者与正常人和非IBS患者的敏感性为95.5%，特异性为71.8%。阳性预测值为85.4%。阴性预测值为90.2%。结论：直肠痛阈值降低是IBS患者的一个特征。直肠恒压器测试是有用的，以确认IBS的诊断和区分IBS从其他原因的腹痛。
Background & Aims: Visceral hypersensitivity was detected in patients with functional gastrointestinal disorders and has been proposed as a biological marker of irritable bowel syndrome (IBS). The purpose of this study was to assess the sensitivity, specificity, and the predictive values of pain thresholds evaluated by rectal distention using an electronic barostat in patients with or without IBS and in control subjects. Methods: Patients were diagnosed according to Rome II criteria. Rectal sensory thresholds were determined in :164 patients (86 IBS patients, 26 painless constipation, 2:1 functional dyspepsia, and 31 miscellaneous conditions) and in 25 normal controls. All subjects underwent a series of rectal isobaric distentions using an electronic barostat. The bag was progressively distended from 0 to 48 mm Hg and, in response to distention, subjects reported on discomfort or pain. Results: Pain thresholds were lower in IBS patients (30.4 +/- 6.7 mm Hg) compared with controls (44.5 +/- 5), painless constipated (45.4 +/- 5.3), functional dyspepsia (39.4 +/- 7.8), and miscellaneous patients (43.2 +/- 5.5). At the level of 40 mm Hg, the sensitivity of the rectal barostat to identify IBS patients from normal subjects and non-IBS patients was 95.5% and its specificity was 71.8%. The positive predictive value was 85.4%. The negative predictive value was 90.2%. Conclusion: Lowered rectal pain threshold is a hallmark of IBS patients. Rectal barostat testing is useful to confirm the diagnosis of IBS and to discriminate IBS from other causes of abdominal pain.