焦俊,张兰花,曾曦,徐胜生,马启玲
JIAO Jun~1,ZHANG Lan-hua~1,ZENG Xi~1,XU Sheng-sheng~1,MA Qi-ling~2(1.Department of Radiology

• 1:贵阳医学院附院影像科
• 2:贵阳医学院附院影像科
• 3:贵阳医学院附院影像科
• 4:贵阳医学院附院影像科

摘要(Abstract)：

目的:探讨正常人及慢传输型便秘患者的结肠动力状况与胃肠激素水平的关系。方法:运用结肠运输试验观察90例正常人及21例慢传输型便秘(STC)患者结肠动力状况,采用放射免疫法测定上述人群餐前、后血胃动素(MTL)、P物质(SP)、神经降压素(NT)、胃泌素(GAS)、血管活性肠肽(VIP)及生长抑素(SS)等浓度。结果:⑴正常组结肠运输试验80%标记物排出时间(80%TT)小于72 h,青中年组结肠动力明显强于老年组(P<0.05);STC结肠运输试验80%TT大于72 h。⑵正常组空腹及餐后MTL、SP、NT、GAS、VIP及SS浓度分别为:(288.00±127.83)、(26.19±19.12)、(46.95±18.12)、(51.00±21.92)、(176.93±126.64)、(17.72±11.68)ng/L和(336.16±116.06)、(36.86±19.08)、(74.24±34.71)、(102.15±49.15)、(152.14±90.72)、(37.30±30.07)ng/L。餐后多数激素分泌增加,其中SS、GAS与餐前比较有显著性差异(P<0.05)。⑶老年组餐前、后MTL、VIP及SS浓度均显著高于中青年组(P<0.05)。⑷正常组随着结肠动力的增强,MTL、VIP、SS浓度递减,SP、NT浓度递增。⑸STC组MTL、SP、NT、GAS、VIP及SS餐前、后浓度分别为:(227.92±90.46)、(30.17±18.71)、(78.75±52.88)、(24.55±15.50)、(169.21±119.16)、(43.13±33.70)ng/L和(267.94±126.68)、(16.27±14.00)、(110.25±97.08)、(74.08±65.98)、(25.92±12.63)、(25.88±11.51)ng/L。其中MTL、GAS餐前、后和VIP、SP餐后低于正常组,SS餐前明显高于而餐后低于正常组,NT餐前后均明显高于正常组。结论:⑴正常结肠运输试验80%TT≤72 h,青中年结肠动力较强。⑵正常人胃肠激素血浓度差异较大,除VIP外,进食后浓度均增高。⑶正常人多种激素浓度变化与结肠动力关系密切,参与调节和影响结肠动力。⑷STC血中多种胃肠激素水平异常,与结肠动力障碍密切相关。
Objective: To study the situation of colon motility,gastrointestinal hormone(GIH) level,and the relationship between the colon motility and GIH levels of healthy adults and patients with slow transit consipation(STC).Methods: Colon motility of 90 healthy adults and 21 patients with STC was observed by colonic transit test,and at the same time,blood motilin(MTL),substance P(SP),neurotensin(NT),gastrin(GAS),vasoactive intestine polypeptide(VIP) and somatostatin(SS) levels before and after meal were checked with radioimmunoassay(RIA). Results: 1) Colonic transit of healthy adults was below 72h 80%TT.The colon motility of young group and middle-aged group was significantly stronger than that of old-aged group.Colon motility of patients with STC was beyond 72h 80% TT.2) The levels of blood MTL,SP,NT,GAS,VIP and SS of healthy adults before and after meal were as follows: 288.00±127.83,26.19±19.12,46.95±18.12,51.00±21.92,176.93±126.64,17.72±11.68 and 336.16±116.06,36.86±19.08,74.24±34.71,102.15±49.15,152.14±90.72,37.30±30.07 respectively.The top levels of gastrointestinal hormones of healthy adults after meal were higher than those before meal.Most of the hormones increased after the meal,specially the levels of blood GAS and SS(P<0.05).3)The levels of blood MTL,VIP and SS of old-aged group were significantly higher than those of young group and middle-aged group(P<0.05).4) In healthy adult group,blood MTL,VIP and SS levels decreased,but blood SP and NT levels increased when colon motility increased.5) Blood MTL,SP,NT,VIP and SS in patients with STC before and after meal were as follows: 227.92±90.46,30.17±18.71,78.75±52.88,24.55±15.50, 169.21±119.16,43.13±33.70 and 267.94±126.68,16.27±14.00,110.25±97.08,74.08±65.98,25.92±12.63,25.88±11.51.Among them,the blood MTL and GAS,before and after meal,were lower than those of healthy adults,and so were blood VIP and SS after meal.Compared with healthy adults,blood SS in patients with STC was significantly higher before meal and significantly lower after meal.The NT levels before and after meal were both higher than those of healthy people.Conclusions: 1) Colonic transit test of healthy adult is 80%TT within 72 hours.The colon motility of young and middle-aged people is stronger than that of old people.2) There are big variations of levels of different gastrointestinal hormones in healthy people.The blood gastrointestinal hormone levels increase after meal,except VIP.3)The level changes of blood gastrointerstinal hormones in healthy adults are closely related to colon motility,and participate the regulation of colon motility.4) The abnormity of blood gastrointerstinal hormone's level is closely related to disorder of colon motility in patients with STC.

关键词(KeyWords)： 便秘;结肠;结肠疾病,功能性;运动障碍;胃肠激素类
constipation;colon;colonic diseases,functional;movement disorders;gastrointestinal hormones

Abstract:

Keywords:

基金项目(Foundation): 贵阳市科学技术局资金资助项目,筑科农[2002(01)]

作者(Author): 焦俊,张兰花,曾曦,徐胜生,马启玲
JIAO Jun~1,ZHANG Lan-hua~1,ZENG Xi~1,XU Sheng-sheng~1,MA Qi-ling~2(1.Department of Radiology

DOI: 10.19367/j.cnki.1000-2707.2005.06.003

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