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功能性消化不良的胃肠运动与胃排空 总被引:3,自引:0,他引:3
功能性消化不良的胃肠运动与胃排空第三军医大学西南医院消化科张树荣综述王振华审校功能性消化不良(functionaldyspepsin,FD)又称非溃疡性消化不良(non-ulcerdyspepsia,NUD)。其病因尚未确定,可能与胃肠运动障碍有关。... 相似文献
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目的了解功能性消化性不良(P-D)、功能性便秘(FC)的胃排空情况,并探讨其相互关系。方法选择符合罗马Ⅲ标准的FD患者63例,单纯FC患者34例,FD+FC患者46例,无消化道症状的健康体检者40例作为对照组,上述所有患者及健康体检者利用^(13)C-辛酸呼气试验(OBT)进行胃排空时间测定。结果①FD组中胃排空延迟发生率占57.1%(36/63),单纯Fc组中胃排空延迟发生率占58.8%(20/34),FC+FD组中胃排空延迟发生率占65.2%(30/46),FD组、单纯FC组与FC+FD组间比较无统计学差异(P〉0.01),三组与对照组均有显著差异(P〈0.01);②单纯FC组与对照组中无重度胃排空延迟病例出现,而FD(占38.1%)、FC+FD(占34.8%)组中重度胃排空延迟病例所占比例较大,均与单纯FC、对照组有显著差异(P〈0.05)。结论胃动力异常与FD、FC的发病密切相关;FC患者重叠FD症状的几率较高;FD与FC尽管均存在胃动力异常,但严重程度不一,指导临床,需区别对待。 相似文献
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老年人功能性消化不良的胃排空研究 总被引:1,自引:0,他引:1
本文通过对81例老年人功能性消化不良症(FD)患者的临床及胃排空功能进行研究,现报告如下。 1 对象和方法 1.1 对象 1993-1994年门诊及住院患者临床诊断为功能性消化不良的50岁以上患者共81例,其中男37例,女44例,女性平均年龄60±6.78岁,男性平均年龄60±8.49岁,均有上腹不适、胀满等消化不良症状,病程四周以上。B超、血糖检查,除外器质性肝胆胰病,神经肌肉病等影响胃排空疾病及上消化道严重糜烂性胃炎、溃疡、肿瘤等,排除糖尿病胃轻瘫。 82例健康志愿者作正常对照组,其中男39例,女43 相似文献
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功能性消化不良患者胃排空的均匀性 总被引:1,自引:0,他引:1
目的:观察功能性消化不良(FD)患者胃排空的情况。方法:采用核素胃排空试验,连续动态观察16例正常人及70例FD患者排空情况。8例FD患者在胃排空试验同时作胃窦十二指肠压力波记录。结果:证实42.9%FD患者胃排空延迟。各时间段胃排空率变异系数为120.7±147.1%,明显高于正常组的73.4±29.7%。结论:FD患者,尤其胃排空延迟者,排空有快慢不均的异常情况。 相似文献
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和胃胶囊对运动障碍样功能性消化不良患者胃排空的影响 总被引:1,自引:0,他引:1
目的:观察和胃胶囊对运动障碍样功能性消化不良(DFD)患者胃排空的影响。方法:随机选取DFD患者12例,设西药对照组和正常对照组,以核素法动态测定DFD患者和胃胶囊治疗前后近端胃、远端胃及全胃的排空情况,并计算近端胃、全胃的半排空时间(T1/2)。结果:DFD患者近端胃、远端胃及全胃的排空速度均较正常人明显减慢(P<0.05-0.01),近端胃、全胃T1/2比正常人延长(P<0.05-0.01);和胃胶囊治疗后,近端胃、全胃排空速度明显加快,全胃T1/2缩短,与治疗前比较差异有显著性意义(P<0.05-0.01),与正常人比较差异无显著性意义。结论:和胃胶囊能明显促进DFD患者的胃排空,是治疗DFD的有效药物。 相似文献
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舒丽启能对功能性消化不良胃排空时间作用研究 总被引:1,自引:0,他引:1
功能性消化不良 (FD)是一发病机制尚未明了的常见病。胃动力障碍可能是其主要发病机制之一[1,2 ] 。近年研究表明[3] ,利用放射技术食用标准试餐加固体小钡条观察胃排空时间为诊断胃排空障碍的可靠手段。 1999年 6月~ 2 0 0 0年 7月 ,我院消化科对4 0例FD患者进行了胃排空时间测定 ,同时比较了服用舒丽启能前后的胃排空时间。现将研究结果报道如下。1 病例与方法1.1 FD患者胃排空时间测定1.1.1 病例选择 :选择FD患者 4 0例 ,均为门诊病人 ,其中男 2 4例 ,女 16例 ,年龄 2 9~ 68岁 ,平均 4 0 .6岁。所有患者均符合参考文献 [4]… 相似文献
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幽门螺杆菌感染对功能性消化不良患者胃排空功能的影响 总被引:1,自引:0,他引:1
目的:探讨幽门螺杆菌(Hp)感染对功能性消化不良(FD)患者胃运动和胃排空功能的影响。方法:13例Hp阳性FD和9例Hp阴性FD患者接受SPECT胃排空检测,获得液体、固体食物的胃排空和胃内分布参数;另外47例Hp阳性FD和21例Hp阴性FD患者在进食10%葡萄糖500ml后采用B超胃窦面积法检测其胃窦收缩幅度(A)、收缩频率(F)、胃窦运动指数(MI)、半排空时间(T(50))和全排空时间(T)。结果:进食lO%葡萄糖500ml后,Hp阳性患者的胃窦收缩幅度(O.29±0.05)、收缩频率(3.9±1.7)、胃窦运动指数(44.7±7.2min)与Hp阴性FD患者无显著差异(A:0.29±0.07;F:3.7±104;MI:0.54±0.24;T_(50):22.9±4.1;T:44.2±6.8;P值均>0.05)。固体和液体食物的半排空时间及胃内分布在Hp阳性和Hp阴性的FD患者中也无显著性差异(P>O.05)。结论:Hp感染不影响FD患者的胃运动和排空功能。 相似文献
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功能性消化不良患者胃固体排空功能与其临床症状关系的研究 总被引:23,自引:2,他引:23
目的研究功能性消化不良运动障碍亚型患者胃固体排空功能与其临床症状的关系.方法对有4周以上腹胀、恶心、食欲减退等症状的患者进行症状评分,症状总积分≥9分,早饱、上腹胀至少具备一项且≥2分者,行胃镜、B超等有关检查,排除器质性病变后诊断为功能性消化不良运动障碍亚型.确诊患者服用标准试餐加固体小钡条,餐后5h透视确定胃内钡条排空情况;同时所观察患者服用西沙必利每次5mg、每日3次治疗,并于治疗2周及4周末复查.结果功能性消化不良运动障碍亚型中67.5%的患者有胃排空异常,女性与男性无显著性差异(P>0.05).治疗前胃排空正常者的症状积分为10.00±1.41,,胃排空异常者为11.70±2.28,二者相比无明显差异(P>0.05);治疗2周及4周后,胃排空正常者的症状积分分别为4.90±2.45、2.10±1.19,胃排空异常者则分别为7.00±3.12、4.20±2.39,与治疗前相比二者的症状总积分均明显降低,而且前者比后者的症状积分更低(P<0.05).治疗前患者的症状积分虽与胃内钡潴留无明显相关(r=0.078,P>0.05),但治疗后二者却有一定的相关性(r=0.47,P<0.05).结论功能性消化不良患者有明显的胃排空延迟;胃排空延迟确与运动障碍样症状有关,但与症状的严重程度无关;西沙必利治疗可使所有患者的症状及部分患者的胃排空不同程度改善. 相似文献
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Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients 总被引:2,自引:0,他引:2
Pallotta N Pezzotti P Calabrese E Baccini F Corazziari E 《World journal of gastroenterology : WJG》2005,11(28):4375-4381
AIM: Delayed gastric emptying and an enlarged fasting gastric antrum are common findings in functional dyspepsia but their relationship with gastrointestinal (GI), and the frequently associated extra-GI symptoms remains unclear. This study evaluated the relationship between GI and extra-GI symptoms, fasting antral volume and delayed gastric emptying in functional dyspepsia. METHODS: In 108 functional dyspeptic patients antral volume and gastric emptying were assessed with ultraso-nography (US). Symptoms were assessed with standardized questionnaire. The association of symptoms and fasting antral volume with delayed gastric emptying was estimated with logistic regression analysis. RESULTS: Delayed gastric emptying was detected in 39.8% of the patients. Postprandial drowsiness (AOR 11.25; 95%CI 2.75-45.93), nausea (AOR 3.51; 95%CI 1.19-10.32), fasting antral volume (AOR 1.93; 95%CI 1.22-3.05), were significantly associated with delayed gastric emptying. Symptoms, mainly the extra-GI ones as postprandial drowsiness and nausea, combined with fasting antral volume predicted the modality of gastric emptying with a sensitivity and specificity of 78%. CONCLUSION: In functional dyspeptic patients, (1) an analysis of fasting antral volume and of symptoms can offer valuable indication on the modality of gastric emptying, and (2) it seems appropriate to inquire on postprandial drowsiness that showed the best correlation with delayed gastric emptying. 相似文献
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幽门螺杆菌感染与功能性消化不良胃排空的关系 总被引:4,自引:0,他引:4
目的:探讨幽门螺杆菌(Hp)感染对功能性消化不良(FD)患者胃排空功能的影响。方法:106例FD患者,其中Hp阳性46例,Hp阴性60例。全部患者从胃窦粘膜取活组织做病理组织学检查并利用实时B型超声胃窦截面积法测定胃排空。结果:Hp阳性患者的空腹胃窦面积、餐后即刻胃窦面积、餐后60分钟和120分钟的胃排空率(分别为094±139cm2、134±316cm2、923±140%和358±235%)与Hp阴性者(分别为119±212cm2、125±2782、912±122%和321%±240%)比较,无显著性差异(P>005);活动性胃炎患者空腹胃窦面积、餐后即刻胃窦面积、餐后60分钟和120分钟的排空率(分别为077±142cm2、132±35cm2、100±122%和347±260%)与非活动性胃炎患者(分别为128±207cm2、127±252cm2、974±145%和332±24%)比较,也无显著性差异(P>005)。结论:Hp感染对FD患者胃排空功能无影响;与Hp感染有密切相关性的活动性胃炎也不足以引起胃排空的改变 相似文献
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目的了解胃排空异常与消化不良症状的相关性,分析影响功能性消化不良(FD)患者胃排空的因素。方法纳入32例FD患者。量化记录餐后上腹饱胀、上腹痛、上腹烧灼感、早饱、嗳气、恶心、呕吐7组症状及静息心率。以心率的中位数将其转化为二分类变量进行非条件Logistic回归分析统计。运用核素闪烁法检测空腹固体试餐,试餐参考美国胃肠动力学会、神经胃肠学会及核医学联合推荐的标准低脂试餐以及诊断标准。结果 32例FD患者,8例(25%)T1/2延迟,7例(21.88%)Retention%2 h增加,Retention%1 h均在正常范围内。Retention%2 h正常组与Retention%2 h增加组以及T1/2正常组与T1/2延长组之间,心率均存在显著差异(P=0.031,P=0.022),心率与Retention%2 h、T1/2存在正相关(r=0.448,P=0.01;r=0.423,P=0.016)。在控制了性别、年龄及其他症状因素的影响下,心率〉70 bpm是Retention%2 h增加、T1/2延长的独立因素(OR=12.378,P=0.042;OR=8.180,P=0.072)。在Retention%2 h正常组与Retention%2 h增加组之间恶心症状指数有显著差异(P=0.003),恶心与Retention%2 h、T1/2存在正相关(r=0.527,P=0.002;r=0.381,P=0.032)。结论心率、恶心症状与功能性消化不良患者的胃排空存在一定相关性,在控制了性别、年龄、BMI及其他症状的因素影响下,静息心率增加、出现恶心症状可能是胃排空延缓的独立因素。 相似文献
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功能性消化不良患者的胃排空和胃内食物分布 总被引:9,自引:1,他引:9
目的:探讨功能性消化不良(FD)患者的胃排空、胃内食物分布情况及其与消化不良症状之间的关系.方法:采用双核素标记试餐SPECT检测FD患者和正常对照组(HC)胃排空功能及胃内食物分布情况,并对60例FD患者的症状进行分级评分.结果:23例(38%)FD患者的固体及液体排空时间同时延迟,40例(67%)FD患者至少存在一项胃内固体食物分布参数异常,液体食物近端胃半排空时间较对照组延长,而在远端胃内的分布两组十分相似.胃排空正常和延迟的FD两组之间各症状积分相似,而在餐后胃内食物分布异常的FD组,恶心和早饱两种症状积分明显高于胃内食物分布正常的FD组.结论:部分FD患者存在胃排空和/或胃内食物分布异常,其中胃内食物分布异常与消化不良症状的严重程度之间存在一定的关系. 相似文献
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不同疾病状态时胃食物排空的变化 总被引:4,自引:1,他引:4
目的:研究不同疾病时胃排空功能变化,探讨胃排空改变在功能性消化不良(FD)和十二指肠溃疡(DU)发病机制中的地位。方法:应用双同位素标记试餐SPECT胃排空检测技术研究17例健康志愿者、22例FD、17例DU、23例糖尿病(DM)、11例进行性系统性硬皮病(PSS)患者在进食液体和固体试餐后食物在胃内的分布、半排空时间及胃排空曲线的变化。结果:病例组的液体排空曲线与对照组相似,但pS3和DU组的液体L’延长(PSS:79.3±19.3;DU:59.0±17.3;对照组:41.6土9.6分钟;P均<0.05)。4个病例组的固体食物胃排空曲线发生类似的变化,即迟滞相消失、初始胃排空较快、继后的排空变慢,其中54.5%FD、81.8%PSS、70.6%DU和56.5%DM患者的固体T50延长,未见固体食物排空加速者。结论:本组FD,DU患者的胃排空模式改变与PSS、DM患者相似,可能是非特异性的,在疾病的发生中可能不起始动性作用。 相似文献
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Relationship between antral distension and postprandial symptoms in functional dyspepsia 总被引:1,自引:1,他引:0
INTRODUCTION Patients with functional dyspepsia (FD)[1] complain of several gastrointestinal (GI) and extra-gastrointestinal (extra-GI) symptoms[2-5] that are usually associated with food ingestion[6]. Several pathophysiological abnormalities have been im… 相似文献
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Chun-Ling Zhang Chang-Hui Geng Zhi-Wei Yang Yan-Lin Li Li-Quan Tong Ping Gao Yue-Qiu Gao 《World journal of gastroenterology : WJG》2016,22(18):4585-4593
AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia (FD) patients.
METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori (H. pylori)-negative group (28 patients), and H. pylori-positive group (42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group (21 patients) and conventional treatment group (21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were given conventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups.
RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group (50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the control group (93.7 ± 26.2 vs 72.0 ± 14.3; 102.2 ± 26.4 vs 87.5 ± 18.2; 102.1 ± 28.6 vs 78.3 ± 14.1; all P < 0.05). Abdominal distension, belching and early satiety had an effect on distal gastric half-emptying time (P < 0.05). Abdominal distension and abdominal pain had an effect on the gastric half-emptying time of the whole stomach (P < 0.05). All were risk factors (odds ratio > 1). The total symptom score of the 3 groups after treatment was lower than before treatment (P < 0.05). Total symptom scores after treatment in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group (5.15 ± 2.27 vs 7.02 ± 3.04, 4.93 ± 3.22 vs 7.02 ± 3.04, All P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the H. pylori-negative and H. pylori-treatment groups were shorter than in the conventional treatment group (P < 0.05).
CONCLUSION: FD patients have delayed gastric emptying. H. pylori infection treatment helps to improve symptoms of dyspepsia and is a reasonable choice for treatment in clinical practice. 相似文献