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| 结肠传输试验及肛门直肠测压在功能性便秘患者精准诊断分型的应用 |
| Study on precise diagnosis and classification of patients with functional constipation based on high-resolution anorectal manometry and colonic transmit test |
| 投稿时间：2024-05-15 |
| DOI：10.3969/j.issn.1000-0399.2025.04.002 |
| 中文关键词: 功能性便秘 结肠传输试验 肛门直肠测压 心理健康 |
| 英文关键词: Functional constipation Colon transport test Anorectal manometry Mental health |
| 基金项目:国家自然科学基金项（编号：31870993） |
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| 中文摘要: |
| 目的 探讨功能性便秘（FC）精准诊断与分型的应用，并分析各个亚型患者的心理及精神状况。方法 纳入 2019 年12 月至 2024 年 2 月从安徽医科大学附属省立医院门诊招募的根据罗马Ⅳ标准被诊断为 FC 的患者 89 例。所有患者均行结肠传输试验（CTT）、高分辨率肛门直肠测压（HRAM），根据结肠传输试验标志物的排出情况来判断患者的便秘类型，利用高分辨率肛门直肠测压对排便障碍型便秘患者进行 Rao 分型。使用汉密尔顿焦虑量表（HAMA）与汉密尔顿抑郁量表（HAMD）来衡量患者的焦虑、抑郁程度，并对比分析各个亚型的心理健康状况。结果 89 例受试的 FC 患者中，慢传输型便秘（STC）患者占所有 FC 患者总数的 47.19%，排便障碍型便秘（DD）患者占 40.45%，混合型便秘（MIX）患者占 5.61%，正常传输型便秘（NTC）患者占 6.75%。DD 组患者抑郁水平高于STC 患者（P<0.001），MIX 患者（P=0.007）和 NTC 患者（P<0.001）组；Rao Ⅰ组患者焦虑水平高于 Rao Ⅱ组（P=0.030），Rao Ⅲ组（P<0.001）和 Rao Ⅳ组（P<0.001）组，差异均有统计学意义。结论 临床可采用病理生理学检查对 FC 患者进行精准分型，更应该关注 RaoⅠ型便秘患者心理健康状况。 |
| 英文摘要: |
| Objective To precisely diagnose and classify patients with functional constipation (FC), and investigate the mental and psychological health status of each subtype of FC patients, and to provide scientific basis for precise FC therapy. Methods A total of 89 FC patients were recruited from the Outpatient Clinics of Anhui Provincial Hospitals between December 2019 and February 2024. All patients underwent high-resolution anorectal manometry (HRAM), colonic transmit test (CTT), and mental health assessment. The type of constipation in the patient was determined based on the colonic transit test, and further classified by high-resolution anorectal manometry. The Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were used to assess the patients’ levels of anxiety and depression, and then the psychological health status were compared among different subtypes. Results Among the 89 patients with functional constipation in the study, patients classified as slow transit constipation were the most common, accounting for 47.19% of the total number of functional constipation patients, and defecation disorder (DD) patients accounted for 40.45%. The depression level of DD group patients was significantly higher than that of slow transit constipation (P<0.001), mixed type constipation (P=0.007), and normal transit constipation (P<0.001) groups. The anxiety level of Rao Ⅰ group patients was significantly higher than that of Rao Ⅱ (P=0.030), Rao Ⅲ (P<0.001), and Rao Ⅳ (P<0.001) groups. Conclusion It is necessary to further classify functional constipation patients using physiological examinations, and clinical doctors should pay more attention to the psychological health status of Rao type Ⅰ constipation patients. |
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