Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation
Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation
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DOI：
10.1111/j.1365-2982.2010.01597.x
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发表时间：
2010-12-01
影响因子：
3.5
通讯作者：
Cook, I. J.
中科院分区：
文献类型：
--
作者：
Dinning, P. G.;Zarate, N.;Cook, I. J.
背景慢传输型便秘（STC）患者结肠传播序列（PS）的形态学、运动反应和时空组织尚未明确。利用时空映射技术，我们的目的是证明“测压签名”，可以作为生物标志物的疾病。方法14例经结肠镜证实的STC患者和8例健康女性对照组，在结肠镜下放置一根硅胶导管，每隔7.5cm有16个记录点，头端夹在盲肠上。记录24 h的管腔内压力。关键结果：首次在STC患者中发现了全结肠24小时时空标测：结肠中部传播压力波明显缺乏（P = 0.01），由于（P < 0.0001）近端结肠起源的PS扩散范围减少，近端结肠逆行PS频率增加; PS间的时空组织性显著降低（P < 0.001）; PS缺乏正常的夜间抑制。结论和推论全结肠，24小时，时空压力映射很容易识别连续PS，活动减少和缺乏或缺乏基本的运动模式和生理刺激的反应的区域之间的特征性紊乱。这些特征在慢传输型便秘的病理生理学中可能都很重要。
Background The morphology, motor responses and spatiotemporal organization among colonic propagating sequences (PS) have never been defined throughout the entire colon of patients with slow transit constipation (STC). Utilizing the technique of spatiotemporal mapping, we aimed to demonstrate 'manometric signatures' that may serve as biomarkers of the disorder. Methods In 14 female patients with scintigraphically confirmed STC, and eight healthy female controls, a silicone catheter with 16 recording sites spanning the colon at 7.5 cm intervals was positioned colonoscopically with the tip clipped to the cecum. Intraluminal pressures were recorded for 24 h. Key Results Pan-colonic, 24 h, spatiotemporal mapping identified for the first time in STC patients: a marked paucity of propagating pressure waves in the mid-colon (P = 0.01), as a consequence of a significant (P < 0.0001) decrease in extent of propagation of PS originating in the proximal colon; an increase in frequency of retrograde PS in the proximal colon; a significant reduction in the spatiotemporal organization among PS (P < 0.001); absence of the normal nocturnal suppression of PS. Conclusions & Inferences Pan-colonic, 24 h, spatiotemporal pressure mapping readily identifies characteristic disorganization among consecutive PS, regions of diminished activity and absent or deficient fundamental motor patterns and responses to physiological stimuli. These features are all likely to be important in the pathophysiology of slow transit constipation.