| Objective :To detect the expression level of 5-hydroxytryptamine(5-HT)or somatostatin(SS)in serum of patients with elderly chronic constipation and anxiety or depression score,and study the correlation between the expression level of 5-HT or SS and anorectal motility.Methods: Patients were enrolled from October 2016 to August 2017 in Department of Healthcare,Qingdao Municipal Hospital,including patients with chronic constipation 97 cases,60 male patients and 37 female patients,And total number of 71 patients without constipation as a control group,including male patients 42 cases and female patients 29 cases.Total number of 75 elderly patients with abnormal defecation including 40 cases with constipation,22 males,18 females,and mean age was(76.1±9.4)years old;35 cases with diarrhea,19 males,16 females,and mean age was(69.7±9.3)years old.During the experiment Enzyme-linked immunosorbent assay was used to determine the content of 5-HT and SS in the serum of the patients;Anal resting pressure,maximal squeeze pressure,initial sensory thresholds,first defecation threshold and the maximum tolerance capacity were detected by perfusion anorectal manometry;Self-rating anxiety scale(SAS)?Self-rating depression scale(SDS)were used to assess the difference scores between the two groups.Result :(1)The expression level of 5-HT in serum of patients with chronic constipation(23.30±6.57)pg/ml was significantly lower than that of control group(29.61±9.49)pg/ml,the difference was statistically significant(t=-3.624,P=0.001);the expression level of SS in serum of patients with chronic constipation(20.82±5.96)pg/ml was significantly higher than the control group(16.92±6.47)pg/ml,the difference was statistically significant(t=2.886,P=0.005);The expression level of 5-HT?SS in serum of patients with chronic constipation of different ages,different gender,and different clinical symptoms was no significant difference(all P>0.05);and the expression level of 5-HT?SS in serum of elderly patients with chronic constipation of different gender,different clinical symptoms was also no significant difference(all P>0.05).(2)The expression level of SS in serum of elderly patients with constipation was negatively correlated with maximal squeeze pressure(MSP)(rMSP=-0.402,P<0.05),there was no correlation in other aspects(all P>0.05);And the expression level of SS in serum of elderly male patients with constipation was negatively correlated with MSP(rMSP=-0.459,P<0.05),there was no correlation in other aspects(all P>0.05);There was no correlation between the expression level of 5-HT or SS and anorectal motility of the patients with diarrhea(all P>0.05),and there was no correlation between the expression level of 5-HT or SS and anorectal motility of the patients with diarrhea in different gender.(3)The integration of SAS and SDS in patients with chronic constipation(SAS:43.03±7.19 points)?(SDS:45.38±9.56 points)were obviously higher than patients without chronic constipation(SAS:38.39±6.56 points)?(SDS:38.54±7.27 points),The difference was statistically significant(t SAS=2.571,PSAS= 0.013;tSDS=3.005,PSDS=0.004);The integration of SAS and SDS in elderly patients with chronic constipation was no significant difference(all P>0.05).The integration of SAS in female patients with chronic constipation was(47.21 ± 7.31 points)higher than the male patients with chronic constipation(40.41 ± 5.85 points),and the difference was significant(t=3.212,P=0.003),However,there was no significant difference in integration of SDS between female and male patients with chronic constipation(t=0.738,P=0.465);The integration of SAS in female elderly patients with chronic constipation was(48.07 ± 7.69 points)higher than the male elderly patients with chronic constipation(41.08 ± 6.13 points),and the difference was significant(t=2.603,P=0.015),And there was no significant difference in integration of SDS between female and male elderly patients with chronic constipation(P>0.05);As different clinical symptoms in patients with chronic constipation,The integration of SDS in chronic constipation patients with abdominal pain was(48.60 ± 8.98 points)higher than the control group(38.94± 7.36 points),the difference was statistically significant(t=3.347,P=0.002),and there was no significance between the two group in the integration of SAS(P>0.05);Patients with or without abdominal distension?defecation difficulty? defecation imcompletion the integration of SAS ?SDS was no statistically significant(all P>0.05).Conclusion:(1)The expression level of 5-HT and SS in serum of the patients with chronic constipation have some characteristics.Gender or age and clinical symptoms are no significant influence with the expression level of 5-HT and SS in the serum of the patients with constipation.(2)The expression level of SS in serum of patients with elderly constipation may be one of the factors that affect the anorectal motility in some aspects,And the expression level of SS in serum has a certain effect on the anorectal motility in elderly male patients with constipation.(3)Patients with chronic constipation had higher scores of anxiety and depression,there is a certain relationship between the gender or abdominal pain and the anxiety or depression. |
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