胃食管反流胃肌电活动变化的研究

目的：探讨正常儿与胃食管反流(GER)患儿的胃肌电活动特点，认识小儿GER的病因及病理生理特征，为治疗提供客观依据和指导。方法：对20例正常儿及20例GER小儿进行胃电图监洲，记录主功率(DP)、主频率等指标。结果：GER患儿主频值明显减低，胃电节律紊乱，以胃动过速为主。GER患儿大多存在胃动力障碍。结论：胃动力障碍，胃-幽门窦-十二指肠蠕动不协调是造成GER的主要因素。胃电图对GER的诊断及治疗具有一定的指导意义。     

Postprandial Response of Gastric Slow Waves: Correlation of Serosal Recordings with the Electrogastrogram

Controversial interpretations have been given to the postprandial increase in the dominant power (amplitude) of the electrogastrogram (EGG). The aim of this study was to find an appropriate interpretation of the postprandial EGG power changes. Simultaneous serosal and cutaneous recordings of gastric myoelectrical activity were made in 11 patients with gastroparesis in the fasting state and after the ingestion of 8 oz of water. The dominant frequency and corresponding power of the recording before and after water were computed using the power spectral analysis method. It was found that the dominant frequency of the EGG was the same as that of the serosal recording in 10 patients. One patient showed a substantial amount of dysrhythmia and no obvious dominant frequency was noted. A decrease in the dominant frequency was found in these 10 patients after the ingestion of water. Tachygastria of higher than 4 cycles/min was observed in one of 11 patients both in the prewater and postwater states. Consistent changes in amplitude after a drink of water were noted in both serosal recording and EGG. Statistical analysis demonstrated that the dominant power change after water computed from the EGG was correlated with that observed in the serosal recording (r = 0.757, P = 0.007). In conclusion, exogenous stimulation, such as ingestion of water, may change the amplitude of the gastric slow wave and this change is reflected in the EGG, suggesting that the change of the slow-wave amplitude is an important contributing factor to the postprandial change in the EGG dominant power.     

肝硬化患者体表胃电图参数与肝功能损害程度的相关性研究

探讨肝硬化患者体表胃电图参数变化与肝功能及检验指标间的关系。对63例肝硬化患者和20例健康志愿者进行体表胃电图记录和化验检查。将健康对照组、Child-pugh分级A级、B级、C级四级受试者进行两两比较,主频和胃电节律紊乱百分比均有显著差异;胃电节律紊乱百分比与肝功能检验指标进行相关性分析,发现白蛋白和血小板计数与胃电节律紊乱百分比存在直线负相关关系(r分别为-0.723和-0.704)。1.肝硬化患者存在明显胃电节律紊乱,并随肝功能损害程度加重而加重;2.白蛋白和血小板计数与肝硬化患者胃电节律紊乱关系密切,可用于判断肝硬化患者胃动力障碍情况。     

酪酸梭菌二联活菌散联合复方胃蛋白酶颗粒治疗小儿功能性消化不良的临床研究

目的 探讨酪酸梭菌二联活菌散联合复方胃蛋白酶颗粒治疗小儿功能性消化不良的临床疗效。方法 回顾性分析2020年2月—2021年2月在郑州大学附属儿童医院诊治的104例功能性消化不良患儿的临床资料,根据就诊顺序分为对照组和治疗组,每组各52例。对照组口服复方胃蛋白酶颗粒,10 g/次,3次/d;治疗组在对照组基础上口服酪酸梭菌二联活菌散,500 mg/次,2次/d。两组患儿治疗2周。观察两组患儿临床疗效,比较治疗前后两组患儿FDDQL评分、临床症状评分、GOSS评分,血清胃肠激素和脑肠肽水平,胃电图指标。结果 经治疗,对照组和治疗组的临床有效率分别为84.62%、98.08%（P<0.05）。经治疗,两组FDDQL评分明显升高,而临床症状评分和GOSS评分明显下降（P<0.05）,且治疗组患儿评分明显好于对照组（P<0.05）。经治疗,两组患儿血清胃动素（MTL）和神经肽Y（NPY）水平明显升高,而胃泌素（GAS）、生长抑素（SS）和血管活性肠肽（VIP）水平均明显下降（P<0.05）,且治疗组患儿血清胃肠激素、脑肠肽水平明显好于对照组（P<0.05）。经治疗,两组患儿平均收缩波频率（MFC）、收缩波幅值（AC）均明显升高（P<0.05）,且治疗组患儿胃电图指标水平明显高于对照组患儿（P<0.05）。结论 酪酸梭菌二联活菌散联合复方胃蛋白酶颗粒治疗小儿功能性消化不良可有效改善患儿临床症状,促进机体胃肠激素、脑肠肽分泌的改善,有利于胃电节律和生活质量的改善。     

168例溃疡病胃电图分析

本文通过对168例经胃镜确诊的溃疡病人进行体表胃电图综合分析,结果表明,胃、十二指肠溃疡的胃电图频率与正常对照(P>0.05)无显著性差异,主要表现在于胃电图的幅值、活动指数、反应而积的改变,与正常对照(P<0.01)有显著性变化,30～40％的胃及十二指肠溃疡病人的胃电图出现明显的节律紊乱。     

Effects of electroacupuncture at different points on colorectal distention-induced changes in blood pressure, electrogastrogram, gastric tension and gastric blood flow

Objective: To investigate the specificity of the effects of electroacupuncture (EA) at different acupoints on gastric functional activity and gastric blood flow after colorectal distension (CRD) in the rat.Methods: Fifty Wistar rats were randomly divided into 5 groups: a control group,a Zusanli group,a non-point group,a Taichong group and a Neiguan group.Rats were anesthetized after 18 h of fasting,and a rat model of nociceptive blood pressure elevation and abnormal electrogastrogram (EGG) and gastric tension (GT) was prepared by gasbag-induced CRD.EA was given bilaterally,and its effects on gastric blood flow (GBF) of the arcus vasculosi of the greater omentum,blood pressure,EGG fast wave properties,and gastric smooth muscle tension (GT) were quantified.Results: CRD induced an increase in blood pressure that was significantly inhibited by EA at all points (all P＜0.05),and the inhibitory effects were greater in the Zusanli and Neiguan groups compared to the non-point group (both P＜0.05).CRD also caused reductions in GT and GBF,and in the amplitude,frequency and duration of EGG waves (all P＜0.05).These effects were also reversed by EA.The effects of EA on EGG wave amplitude,GT,and GBF were superior in the Zusanli group compared to the Taichong group,Neiguan group,and the non-point group.Conclusion: EA significantly counteracted CRD-induced changes in blood pressure,GBF,EGG; and GT.The effects of stimulation at Zusanli (ST 36) were significantly greater compared to other points,indicating relative specificity of this acupoint.     

Gastric myoelectrical differences between Parkinson's disease and multiple system atrophy

The electrogastrogram (EGG) was recorded for 24 hours in 17 Parkinson's disease (PD) patients, 17 multiple system atrophy (MSA) patients, and 8 healthy control subjects to elucidate the differences in the EGG findings between the two diseases. Eight EGG segments (3 preprandial, 3 postprandial, and 2 sleep segments) were selected from the total recording for spectral analysis, from which we obtained the dominant frequency (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power. PD patients showed irregular slow waves, high HFR%, and high ICDF, whereas MSA patients showed regular slow waves and low ICDF. Although DF and NFR% increased after meal in controls, postprandial increases in DF and NFR% were less significant in both patient groups compared to the controls. The PD patients presented gastric dysrhythmias indicating gastric pacemaker disturbances. The MSA patients showed regular slow waves with low variability of the slow wave rhythm (low ICDF), which might have resulted from the involvement of gastric autonomic nerve function. © 2009 Movement Disorder Society     

Isopower maps of the electrogastrogram (EGG) after total gastrectomy or total colectomy

Isopower or topographic electrogastrograms (EGG) correspond to topographic electroencephalograms. Both project the topographic localizations of the spectral frequencies on the abdominal surface or scalp. This paper compares the pre-operative control isopower EGG maps with those of total gastrectomy or total colectomy. EGGs were recorded simultaneously at 27 locations on the epigastro-abdominal surface. Spectral analysis by the maximal entropy method (MEM) was performed and the ensemble means of pre-prandial and post-prandial spectra were calculated. The spectral frequencies were arbitrarily classified into five groups, 1 cycle per minute (cpm) (0-2.4 cpm), 3 cpm (2.5-4.9 cpm), 6 cpm (5.0-7.4 cpm), 8 cpm (7.5-9.9 cpm) and 10 cpm (10.0-12.9 cpm). Maximal power peaks in each spectral group, and electrode locations which were expressed by x-y coordinates were the indicators for making the isopower EGG maps by using a contour map program. Thereafter, the maximal power spots or foci in each spectral group were determined. The pre-operative maximal power foci of the 1, 8 and 10 cpm groups were distributed rather evenly on the epigastro-abdominal surface. Those of the 3 and 6 cpm groups, mainly concentrated in the epigastric region, were absent in almost all patients who had undergone total gastrectomy. The infra-umbilical foci of the 3 and 6 cpm groups completely disappeared after total colectomy. The infra-umbilical foci of the 3 and 6 cpm groups (2.5-7.4) may reflect the colonic activities and the epigastric 3 cpm foci, the gastric activities. The pre-operative maximal power of the 3 cpm foci decreased significantly after total or sub-total gastrectomy.     

胃电慢波节律百分比计算方法改进

目的 从功率谱估计和计算规则两方面对胃电慢波节律百分比的计算方法进行改进.方法 首先引入线性调频Z变换估计功率谱,即具有较高频域分辨率,又能很好地估计能量;其次在计算百分比时引入主要频率成分的能量信息,用以反映各成分的大致时间分配情况.结果 与传统方法相比,新方法计算结果的方差约减小为原来的1/8,算法更稳定.结论 本文提出的新方法受到分帧情况的影响明显小于传统方法,在计算异常慢波频发的胃电数据的慢波节律百分比时,具有一定的意义.