非溃疡性消化不良患者胃窦壁内胆碱能、SP能神经与胃排空关系的研究

本研究应用酶组织化学及免疫细胞化学方法对31例非溃疡性消化不良(NUD)患者(19例胃液体排空正常的患者为NUDI组、12例胃液体排空延迟的患者为NUD2组)及4例“正常”人胃窦壁内乙酰胆碱酯酶(AchE)、P物质(SP)进行了定位研究,并用图像测量方法对3组胃窦壁内AchE、SP进行了定量分析。结果发现:①NUD2组患者冒窦粘膜肌     

非溃疡性消化不良患者胃窦壁内NO能,VIP能神经与胃排空关系的研究

目的探讨非溃疡性消化不良（NUD）患者胃运动障碍的发生机制。方法应用酶组织化学及免疫细胞化学方法结合图像分析系统对31例NUD患者（19例胃液体排空正常的患者为NUD1组和12例胃液体排空延迟的患者为NUD2组）及4例“正常”人胃窦壁内一氧化氮合酶（NOS，一氧化氮定位标志酶）、血管活性肠肽（VIP）进行了定位、定量研究。结果NUD2组患者胃窦粘膜肌内NOS、VIP阳性神经纤维比NUD1组、“正常”组明显增多、增粗，染色增强，粘膜下层易见到NOS阳性神经节细胞和丛内突起，NUD1组与“正常”组类似；NUD2组NO-S、VIP阳性神经的面积、平均吸光度值与NUD1组、“正常”组之间差异有显著性（P＜0．01）；胃液体半排空时间（T1／2）与三组NOS、VIP阳性神经的面积、平均吸光度值之间均有良好的相关性。结论胃液体排空延迟的NUD患者胃窦壁内NOS、VIP阳性神经纤维和末梢明显增多、活性增强。提示胃窦壁内NO能、VIP能抑制性神经异常改变在NUD患者的胃运动障碍中具有一定的作用。     

老年非溃疡性消化不良患者胃液体排空与血浆胃动素、生长抑素关系的研究

采用实时超声显像法与放射免疫法,对20例老年NUD患者及15例对照者进行胃液体排空时间的测定及血浆胃动素、生长抑素的检测,探讨老年NUD患者目排空运动与胃肠激素之间的关系.结果显示:老年NUD患者胃液体排空T1/2为39.00±11.65min,较对照组的29.33±7.99min明显延迟(P<0.01).老年NUD患者胃动素浓度为471.5±63.06pg/ml,生长抑素浓度为63.83±11.88pg/ml,较对照组分别下降和升高(P均<0.01).老年NUD患者胃液体排空T1/2与胃动素浓度呈负相关(r=-0.936,P<0.01),与生长抑素浓度呈正相关(r=0.942,P<0.01).表明老年NUD患者胃液体排空障碍与胃动素分泌下降及生长抑素分泌增高相关.     

非溃疡性消化不良患者胃液体排空功能与肥大细胞超微结构的关系

为了探讨非溃疡性消化不良（NUD）患者胃液体排空功能与肥大细胞超微结构之间的关系,本文对胃液体排空正常组和排空延迟组各4例NUD患者进行了研究。每例活检胃窦部粘膜1块,行电镜检查,观察肥大细胞形态,计数细胞内颗粒数和已释放介质颗粒数,计算细胞内颗粒面积与细胞总面积之比。结果示NUD患者中排空延迟者肥大细胞脱颗粒增多,提示肥大细胞与NUD患者胃液体排空功能关系密切。     

胃液、血清一氧化氮与功能性消化不良患者胃排空及幽门螺杆菌关系初探

目的探讨功能性消化不良(Functional Dyspepsia,FD)患者胃液及血清一氧化氮(Nitric Oxide,NO)含量与胃液排空的关系;幽门螺杆菌(Helicobacter pylori,H.Pylori)感染对FD患者胃液及血清NO含量的影响.方法选取54例FD患者、20位无症状健康志愿者,分别进行胃液排空时间、H.pylori感染的检查;以亚硝酸盐法检测空腹胃液及血清中NO浓度.结果 H.pylori阳性与H.pylori阴性的FD患者比较,胃液及血清NO含量无明显差异(P＞0.05),在胃排空延迟FD患者中H.pylori阳性及H.pylori阴性患者胃液及血清NO含量亦无明显差异(P＞O.05);FD患者胃液NO浓度明显高于无症状健康志愿者(P=0.01),血清NO浓度也高于无症状志愿者,但无统计学差异(P＞0.05),胃排空延迟的FD患者血清NO浓度与无症状健康志愿者相比P=0.056,而那些胃排空显著延迟(≥50 nin)的FD患者血清NO浓度明显高于无症状健康志愿者(P＜0.01);胃排空延迟的FD患者与胃排空正常的FD患者比较,胃液及血清NO含量增加,但以胃液NO浓度增加意义显著(83.0±10.4 vs 72.9±8.3,P＜0.001),血清NO浓度仅在胃排空显著延迟(≥50 min)的FD患者出现有统计学意义的增高(161.4±16.1 vs 139.3±22.9 P＜0.01),FD患者胃排空时间与胃液NO浓度呈直线正相关(r=0.53,P＜0.01),FD患者胃排空时间与血清NO浓度无直线相关性(r=0.19,P＞0.05),FD患者胃液NO浓度的稳定性高于血清(变异系数13.6%vs 16.5%).结论 H.pylori感染不影响FD患者血清及胃液NO浓度;FD患者胃排空延迟者胃液NO浓度增高,血清NO浓度仅在胃排空时间显著延长者增高;胃液NO浓度较血清NO浓度更稳定,胃液NO浓度与FD患者胃排空时间呈正相关;在研究FD患者胃排空与NO关系时,胃液NO浓度较血清NO浓度更稳定、更具有代表意义.     

β—内啡肽与脾虚证关系的研究

应用放免法测定了20名正常人和109例脾虚证患者的血浆、胃液及胃窦十二指肠粘膜组织的β—内啡肽(β—EP)含量,并观察了进食对血浆β—EP含量的影响。结果显示,正常人血浆β—EP浓度高于胃液,十二指肠粘膜高于胃窦,进食对血浆β—EP浓度无明显影响。在脾虚证中,脾虚夹寒、脾虚夹热、脾虚夹郁型的胃液和胃窦β—EP含量及前两型十二指肠β—EP含量,均低于对照组,脾胃阴虚型降低尤为显著;但空腹血浆前三型升高而后者降低。提示脾虚证患者有β—EP失调而主要表现为减少,并可能在其病机中发挥作用。     

功能性消化不良腹胀与胃排空关系探讨

[目的]探讨功能性消化不良（FD）腹胀症状与胃液体排空的关系。[方法]对152例伴腹胀FD患者和56例不伴腹胀的FD患者，分别进行胃B超液体排空试验，通过测量胃窦（远端胃）和胃底体交界（近端胃）切面面积，计算胃液体排空率，从而判断液体排空情况。[结果]腹胀组152例，排空延迟130例，非腹胀组56例，排空延迟39例，2组比较差异有统计学意义（P＜0．01）；腹胀组130例胃排空延迟患者中，远端胃104例，近端胃116例，2者比较差异有统计学意义（P＜0．05）。[结论]FD患者腹胀症状与胃液体排空延迟有关；近端胃液体排空延迟较远端胃多见。     

消化系统疾病

,82676联合测定胃病息者血浆及胃宾粘膜胃泌素生长抑寮的意义研究/徐军全…刀山西医药杂志一1998,27(1)一17~18 检测13例轻度浅表性胃炎(CSG)、25例胃溃疡(GU)及12例胃癌(GC)患者,结果示血浆胃窦粘膜胃泌素(Gas)在GU组显著高于CSG组(P<0.05);胃窦粘膜Gas则呈现GC组>GU组>CSG组的趋势,但仅在GC与CSG组间有统计学差异。血浆生长抑素(Ss)为GC组相似文献   

氨氯地平并苯那普利对高血压患者血浆一氧化氮与内皮素的影响

目的:评价氨氯地平、苯那普利单独和联合治疗对高血压患者血浆一氧化氮(NO)和内皮素(ET)的影响。方法:选择126例高血压患者随机分为3组,氨氯地平组(A组,41例,接受氨氯地平治疗);苯那普利组(B组,45例,接受苯那普利治疗);联合治疗组(C组,40例,接受氨氯地平和苯那普利治疗)。于治疗前、后行血压及血浆NO、ET测定,并与40例正常对照组血浆NO、ET水平对照。结果:较之对照组,三组高血压患者NO水平显著降低(P<0.01),ET水平显著升高(P<0.01)。三组治疗后血压、ET水平均有显著下降(P均<0.01),A组及B组下降幅度无显著差异,C组下降幅度明显高于A组和B组的(P<0.05);三组血浆NO水平均有显著升高(P均<0.01);A组及B组血浆NO水平升高无显著差异(P>0.05),C组NO升高幅度明显高于A组和B组的(P<0.05)。结论:氨氯地平和苯那普利单独治疗均可明显降低血压和血浆ET水平,同时升高血浆NO水平,而两药联用疗效更佳。     

非溃疡性消化不良患者体表胃电图与幽门螺杆菌关系的研究

目的探讨幽门螺杆菌(Hp)对非溃疡性消化不良(NUD)患者体表胃电图的影响.方法通过胃镜活检胃窦粘膜进行快速尿素酶试验及Giemsa检查以判定Hp感染状态,并对NUD患者空腹体表胃电图与Hp二者的关系进行了评价.结果35例NUD患者Hp阳性(Hp+)24例、Hp阴性(Hp-)11例,Hp+NUD患者AP值明显高于Hp-NUD患者及健康人(胃体269.61±81.11μv、148.10±61.32μv、156.75±71.73μv;胃窦272.94±68.45μv、150.41±71.11μv、193.50±98.74μv,P＜0.01);而FP值前者显著低于后两者(胃体1.77±0.36cpm、2.80±0.77cpm、2.93±0.38cpm;胃窦1.80±0.49cpm、2.85±0.63cpm、2.98±0.28cpm,P＜0.01);正常慢波百分比值,前者也明显降低(胃体41.07±12.67%、59.57±19.41%、68.49±1.95%;胃窦31.84±15.67%、60.58±21.59%、19.19±4.34%,P＜0.01);并且Hp+NUD患者胃电节律紊乱发生率亦显著多于后两者(胃体37.5%、18.2%、11.1%;胃窦45.8%、18.2%、0,P＜0.01).结论Hp+NUD患者胃电节律紊乱发生率明显高于Hp-NUD患者及健康人,Hp感染可能导致正常慢波的紊乱.     

Gastrointestinal hormone abnormalities and G and D cells in functional dyspepsia patients with gastric dysmotility

AIM: To investigate the relationship between gastric dysmotility, gastrointestinal hormone abnormalities, and neuroendocrine cells in gastrointestinal mucosa in patients with functional dyspepsia (FD). METHODS: Gastric emptying was assessed with solid radiopaque markers in 54 FD patients, and the patients were divided into two groups according to the results, one with delayed gastric emptying and the other with normal gastric emptying. Seventeen healthy volunteers acted as normal controls. Fasting and postprandial plasma levels and gastroduodenal mucosal levels of gastrointestinal hormones gastrin, somatostatin (SS) and neurotensin (NT) were measured by radioimmunoassay in all the subjects. G cells (gastrin-producing cells) and D cells (SS-producing cells) in gastric antral mucosa were immunostained with rabbit anti-gastrin polyclonal antibody and rabbit anti-SS polyclonal antibody, respectively, and analyzed quantitatively by computerized image analysis. RESULTS: The postprandial plasma gastrin levels, the fasting and postprandial plasma levels and the gastric and duodenal mucosal levels of NT were significantly higher in the FD patients with delayed gastric emptying than in those with normal gastric emptying and normal controls. The number and gray value of G and D cells and the G cell/D cell number ratio did not differ significantly between normal controls and the FD patients with or without delayed gastric emptying. CONCLUSION: Our findings suggest that the abnormalities of gastrin and NT may play a role in the pathophysiology of gastric dysmotility in FD patients, and the abnormality of postprandial plasma gastrin levels in FD patients with delayed gastric emptying is not related to the changes both in the number and gray value of G cells and in the G cell/D cell number ratio in gastric antral mucosa.     

Effects of Helicobacter pylori infection on gastric emptying rate in patients with non-ulcer dyspepsia

AIM: The pathogenesis of delayed gastric emptying in patients with non-ulcer dyspepsia (NUD) remains unclear. We aimed to examine whether gastric emptying rate in NUD patients was associated with Helicobacter pylori (H pylori) infection and whether it was affected by eradication of the infection. METHODS: Gastric emptying rate of a mixed solid-liquid meal was assessed by the paracetamol absorption method in NUD patients and asymptomatic controls (n=17). H pylori status was assessed by serology and biopsy urease test. H pylori-positive NUD patients (n=23) received 10-day triple eradication therapy. H pylori status was re-assessed by biopsy urease test four weeks later, and if eradication was confirmed, gastric emptying rate was re-evaluated. RESULTS: Thirty-three NUD patients and 17 controls were evaluated. NUD patients had significantly delayed gastric emptying compared with controls. The mean maximum plasma paracetamol concentration divided by body mass (Cmax/BM) was 0.173 and 0.224 mg/L.kg respectively (P=0.02), the mean area under plasma paracetamol concentration-time curve divided by body mass (AUC/BM) was 18.42 and 24.39 mg.min/L.kg respectively (P=0.01). Gastric emptying rate did not differ significantly between H pylori-positive and H pylori-negative NUD patients. The mean Cmax/BM was 0.172 and 0.177 mg/L.kg respectively (P=0.58), the mean AUC/BM was 18.43 and 18.38 mg.min/L.kg respectively (P=0.91). Among 14 NUD patients who were initially H pylori-positive, confirmed eradication of the infection did not significantly alter gastric emptying rate. The mean Cmax/BM was 0.171 and 0.160 mg/L.kg before and after Hp eradication, respectively (P=0.64), the mean AUC/BM was 17.41 and 18.02 mg.min/L.kg before and after eradication, respectively (P=0.93). CONCLUSION: Although gastric emptying is delayed in NUD patients compared with controls, gastric emptying rate is not associated with H pylori status nor it is affected by eradication of the infection.     

乙酸性胃溃疡大鼠一氧化氮、内皮素及表皮生长因子受体相互关系研究

目的 :探讨一氧化氮 (NO)、内皮素 (ET- 1)、表皮生长因子受体 (EGFR)在乙酸性慢性胃溃疡大鼠中的作用及相互关系。方法 :采用乙酸性慢性胃溃疡疾病模型 ,游标卡尺测定溃疡指数 ,硝酸还原酶法测定 NO含量 ,放射免疫法检测血浆 ET- 1含量 ,SABC免疫组织化学方法及图像分析观察 EGFR在溃疡周围粘膜的表达。结果 :左旋精氨酸 (L - Arg)组溃疡指数与模型组及亚硝基左旋精氨酸 (L - NNA )组比较显差有显著性意义 (P <0 .0 5 ,<0 .0 1) ;L- Arg组血清 NO及血浆 ET- 1含量与对照组、模型组及 L- NNA组比较差异有显著性意义 (P <0 .0 5 ,<0 .0 1) ;L - NNA组血清 NO及血浆 ET- 1含量与模型组及对照组比较差异均有非常显著性意义 (均 P <0 .0 1) ;L -Arg组 EGFR表达较模型组、L- NNA组及对照组显著增加 (积分光密度值及阳性细胞占总面积百分比均 P <0 .0 5 ) ;L- NNA组 EGFR显著弱于模型组 (P<0 .0 1)。结论 :NO前体 L- Arg可以诱导、促进 NO合成 ,反馈性地抑制 ET- 1的释放 ,从而维持 NO和 ET的动态平衡及胃粘膜 EGFR正常水平表达 ,促进溃疡愈合。     

Effect of Helicobacter pylori on gastric emptying in non-ulcer dyspepsia--evaluation of Helicobacter pylori by 13C-urea breath test]

AIM: Non-ulcer dyspepsia (NUD) is a common disorder in clinical field. The pathogenesis of NUD are still unclear especially the participation of Helicobacter pylori (H. pylori) in NUD is controversy. Aim of the present study was to clarify the effect of H. pylori at view of urea breath test on liquids and solids gastric emptying in patients with NUD. SUBJECTS AND METHODS: H. pylori positive (n = 24) and negative NUD subjects (n = 11), and H. pylori positive non-NUD subjects (n = 10) as control group were studied. Liquids and solids gastric emptying was evaluated according to the acetaminophen method and sulfamethzole modified method delta 13C-AUC was calculated as estimation of H. pylori by 13C-urea breath test. H. pylori positive NUD was classified into high delta 13C-AUC group (n = 11), median group (n = 8) and low group (n = 5). High delta 13C-AUC group (n = 6) and low delta 13C-AUC group (n = 4) group were treated by eradication therapy. In H. pylori positive NUD subjects, high and low delta 13C-AUC group were estimated the changes of liquids and solids gastric emptying, symptoms before and after eradication. RESULTS: H. pylori positive NUD group has higher liquids gastric emptying that H. pylori negative NUD group (7.6 +/- 2.8 vs. 4.9 +/- 1.4, p = 0.0022). No difference was observed between H. pylori positive and H. pylori negative group of solids gastric emptying. There was no significant difference in liquids gastric emptying among high-, median- and low-delta 13C-AUC group of H. pylori positive NUD subjects. Solids gastric emptying was significantly delayed in high delta 13C-AUC group compared with low delta 13C-AUC group (10.3 +/- 3.7 vs. 5.3 +/- 3.1, p = 0.014). delta 13C-AUC was not correlated to liquids gastric emptying, but to solids gastric emptying (r = -0.573. p = 0.006). In Non-NUD group as control group, delta 13C-AUC has not correlation to liquids and solids gastric emptying H. pylori positive NUD has higher delta 13C-AUC than Non-NUD group. Eradicated low delta 13C-AUC group did not show significant changes in liquids gastric emptying, but did improvement of solids gastric emptying and symptoms scores. Eradicated low delta 13C-AUC group did not show any significant changes. CONCLUSION: In non-ulcer dyspepsia patients H. pylori does not influence liquids gastric emptying, but does solids gastric emptying according to delta 13C-AUC of H. pylori, especially high delta 13C-AUC patients.     

功能性消化不良患者胃排空障碍与胃肠激素的关系

目的 探讨功能性消化不良(FD)患者胃排空障碍与胃肠激素间的关系。方法 对54例四患者进行胃排空检查，根据结果将其分为胃排空延缓的FD组(FDD组)和胃排空正常的四组(FDN组)，另以17名正常人作为对照组。用放免法测定受试者血浆(空脂和餐后)、胃窦十二指肠粘膜组织的神经降压素(NT)和胃动宗(MTL)含量。结果 FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的NT含量均明显高于对照组及FDN组。各组试餐前后血浆NT增幅差异无显著性。FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的MIL含量均明显低于对照组及FDN组。各组十二指肠粘膜组织MTL含量均明显高于胃窦粘膜。结论 FD患者胃排空障碍与NT、MIL密切相关。NT、MIL在FD的发病机制中可能具有一定作用。     

健脾消痞浸膏对脾虚动物胃功能的影响

目的:观察健脾消痞浸膏对脾虚动物胃功能的影响.方法:用大黄水煎剂造脾虚动物模型,以比色法测定液体的胃排空,胃残留物重量测定固体的胃排空,放射免疫法测定血浆胃动素(MTL),用滴定法了解胃分泌功能.结果:健脾消痞浸膏组胃内液体残留率显著降低(P<0.01);中、高剂量组胃内固体残留率降低(P<0.05,<0.01);中、高剂量组血浆MTL、总酸度、总酸排出量升高(P<0.05,<0.01);高剂量组胃液量显著升高(P<0.01).结论:健脾消痞浸膏促进脾虚动物胃排空液体及固体,提高血浆MTL,促进胃液分泌.     

Relationship between antral distension and postprandial symptoms in functional dyspepsia

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…