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Absence of high amplitude propagating contractions in subjects with chronic spinal cord injury

World Journal of Gastroenterology 2010年第43期16卷 5435-5439页

作者： Hanumantha R Ancha Noel R Fajardo William A Bauman Alan S Rosman Marinella Galea graham creasey Mark A Korsten Rehabilitation Research and Development Center of Excellence for Medical Consequences of Spinal Cord Injury James J. Peters VA Medical Center Medical Service James J. Peters VA Medical Center Department of Medicine Mount Sinai School of Medicine Department of Rehabilitation Medicine Mount Sinai School of Medicine Spinal Cord Injury Service James J. Peters VA Medical Center Spinal Cord Injury Service VA Medical Center

AIM: To investigate the presence or absence of high amplitude propagating contractions (HAPC), as well as the other measures of colonic motility, in persons with spinal cord injury (SCI). METHODS: Prolonged colonic ambulatory manometric studies were performed on 14 male volunteers: 8 with SCI (mean age, 59 ± 13 years; mean duration of injury, 13 ± 4 years) and 6 healthy able-bodied controls (mean age, 57 ± 10 years). A solid-state manometry catheter was endoscopically clipped to the splenic flexure. Recording was performed for > 24 h after manometric catheter placement. RESULTS: HAPC were absent in individuals with SCI during pre-sleep, sleep, and post-sleep phases. HAPC were significantly increased after awakening in non-SCI controls (0.8 ± 0.2 HAPC/h vs 10.5 ± 2.0 HAPC/h, P < 0.005). The motility index was lower in those with SCI than in controls preand post-sleep (SCI vs non-SCI: Pre-sleep, 2.4 ± 0.4 vs 8.8 ± 1.9, P < 0.01; Post-sleep, 4.3 ± 0.8 vs 16.5 ± 4.5, P < 0.05). However, a sleepinduced depression of colonic motility was observed in both the SCI and non-SCI groups (Pre-sleep vs Sleep, non-SCI: 8.8 ± 1.9 vs 2.1 ± 0.9, P < 0.002; SCI: 2.4 ± 0.4 vs 0.2 ± 0.03, P < 0.001), with the motility index of those with SCI during sleep not significantly different than that of the controls. CONCLUSION: HAPC were not observed in individuals with SCI preor post-sleep. A sleep-induced depression in general colonic motility was evident in SCI and control subjects.

关键词： Spinal cord injury Neurogenic bowel Bowel motility High amplitude propagating contractions Motility index

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