功能性消化不良患者体表胃电参数与血胃肠激素变化的关系

目的探讨功能性消化不良(FD)患者体表胃电变化与血浆胃肠激素变化的关系以及胃肠激素在 FD 发病中的可能作用及其临床意义。方法对58例 FD 患者与15例健康对照者进行体表胃电图检测;应用放免法测定患者空腹血浆胃动素、生长抑素及胆囊收缩素含量;观察20例 FD 患者西沙比利治疗前后胃电图(主频和振幅)及血浆胃肠激素变化。结果 FD 患者体表胃电参数示主频(Fp)与平均振幅(Ap)均较对照组降低(P<0.01);FD 患者基础血浆胃动素(MTL)低于对照组(p<0.01),胆囊收缩素(CCK)与生长抑素(SS)均高于对照组(P<0.01);FD 患者胃电参数 Ap 和 Fp 与 MTL 呈正相关(p<0.01),与 CCK 及 SS 呈负相关(p<0.01);西沙比利治疗后 Ap 及 Fp 提高,MTL 上升。总有效率90％(18/20)结论功能性消化不良患者体表胃电变化与血浆胃动素降低,胆囊收缩素和生长抑素增高相关。胃肠激素可能参与了功能性消化不良的发病或病理生理过程。     

慢性功能性便秘患者消化不良症状、胃电活动与胃排空研究

在功能性胃肠病中症状重叠现象很常见,研究显示功能性消化不良、慢性功能性便秘、肠易激综合征和胃食管反流病之间存在症状重叠现象。但慢性功能性便秘和功能性消化不良症状重叠现象的研究少见报道。本研究对伴有消化不良症状的慢性功能性便秘患者进行症状评分、胃电图和胃排空研究,初步探讨和分析重叠症状、胃电活动和胃动力障碍的特点。     

功能性消化不良体表胃电及频谱分析

观察了１０名功能性消化不良病人及１０名健康餐前和餐后４小时的体表胃电频谱变化，结果显示，餐后两组的ＡＰ、ＦＺ、ＦＣ和ＦＰ的峰值均显著增加，两组间差异不显著。ＦＤ组ＦＺ总发生率１０．１％，高于ＨＳ组，ＦＰ也高于ＨＳ组。     

精神心理因素对功能性消化不良患者胃电活动的影响

目的 :探讨在功能性消化不良 (FD)患者中精神心理因素与胃电之间的关系。方法 :对 43例FD患者同时进行精神心理状态测量和体表胃电图检查。结果 :伴焦虑抑郁FD组餐后胃电节律异常的发生率显著高于不伴焦虑抑郁FD组 (39.1 %vs1 0 % )。伴焦虑抑郁FD组发生的胃电节律异常主要是胃电节律过缓和胃电节律紊乱。前者的餐后平均主频不稳定系数显著高于后者 (41 .8± 2 7.4vs32 .6± 2 3 .1 )。结论 :精神心理异常可影响胃电活动 ,产生异常的胃电活动     

功能性消化不良与胃运动功能障碍探索

目的探讨功能性消化不良与胃运动功能障碍之间关系．方法对34例功能性消化不良患者进行体表胃电图检查，采用计算机分析其平均胃电频率，以（3．06±0．1）次／min为正常．由于临床上无法设立正常或空白对照，故将该组患者的胃电频率与正常值作差异性u检验．结果34例功能性消化不良患者中25例胃电频率＜2．96次／min，正常7例，2例＞3．16次／min，胃电频率异常率为79．3％．34例胃电平均频率为（2．817±0．125）次／min，与正常值作均数u检验，u＞1．96，P＜0.05．结论功能性消化不良患者存在胃运动功能障碍，功能性消化不良与胃运动功能障碍之间存在联系．     

胆囊收缩素与功能性消化不良患者胃电活动及胃运动相关性的临床研究

胆囊收缩素 (ＣＣＫ)是一种具有广泛生物活性的脑肠肽 ,能引发胃电节律失常及胃运动功能障碍。我们旨在探讨功能性消化不良 (ＦＤ)患者血浆ＣＣＫ浓度与胃电活动及胃排空运动的相关性。一、资料与方法1.对象 :对照组 15例 ,男 12例 ,女 3例 ,年龄 2 3～ 5 8岁 ,平均 2 9岁 ,均无消化系统疾病及胃肠道症状 ,无腹部手术史。ＦＤ组 2 8例 ,男 2 3例 ,女 5例 ,年龄 2 5～ 5 4岁 ,平均 32岁。受试前 1周禁用影响消化道运动功能的药物。2 .方法 :①胃肌电活动测定 :用ＹＷＣ 4型胃肠电放大仪、30 6 6型多导生理记录仪进行空腹及试餐状态下 ,从肘静…     

功能性消化不良的体表胃电图研究

研究功能性消化不良（ＦｕｎｃｔｉｏｎａｌＤｙｓｐｅｐｓｉａ,ＦＤ）体表胃电图,探讨ＦＤ发病的病理生理机制。方法２３名ＤＦ患者及２０名健康志愿者,应用ＤｉｇｔｌａｐｐｅｒＥＧＧ记录仪进行ＥＧＧ检查,检查时间为餐前半小时、餐后回小时,试餐４％Ｋｃａｌ（５０ｇ火腿肠、营多牌方便面１包、４００ｍｌ开水）。结果健康组餐前主频（ｐＦ）、主功率（ＤＰ）、正常节律百分发比（Ｎ％）为：２．９±０．１ｃｐｍ、５７．６±１５．２ｂｐ、９０．９±１．９％;餐后：３．０１０．ＩＣｐｍ、２１２．７８±７２．５ｂｐ（Ｐ＜０．０１）、９２．６±２．１％。ＦＤ组餐前ＤＦ、ＤＰ、Ｎ％为：２．８±０．１ｃｍｐ、４８９．１±１５７．９ｂｐ、８１．８６±５．５％;餐后分别为：３．１±０．２ｃｐｍ、４７５．５±１２２．３ｂｐ、６７．５±４．４％（Ｐ＜０．０５）。结论ｍ患者存在胃电节律紊乱,此种节律紊乱主要表现在餐后功率降低及正常节律百分比下降,提示ＦＤ患者可能存在胃肌电活动异常。ＥＧＧ作为一种无创性胃动力检查方法,可用于ＦＤ患者的临床及研究工作。     

阿米替林对功能性消化不良症状及胃动力的作用

研究功能性消化不良（ＦＤ）患者的胃排空和胃电特性以及阿米替林对ＦＤ的疗效。方法：用双同位素标记ＳＰＥＣＴ技术和体表胃电图检测４２例ＦＤ患者服用小剂量阿米替林前后胃运动功能的变化。结果：ＦＤ组和对照组液相排空曲线相似,半排空时间（Ｔ５０）差异无显著性;ＦＤ组固相Ｔ５０较对照组显著延长,胃电节律紊乱率及餐后振幅降低率较对照组显著增加。阿米替林治疗４周后,ＦＤ患者的临床症状显著改善,但胃排空异常率及胃电     

感染后功能性消化不良患者胃黏膜肠嗜铬细胞的改变

背景：已证实肠嗜铬细胞（EC细胞）在感染后肠易激综合征（PI-IBS）的发生中起重要作用。功能性消化不良（FD）与IBS同属功能性胃肠病范畴,推测感染后FD（PI-FD）与PI-IBS可能存在相似的发病机制。目的：观察PI-FD患者胃黏膜EC细胞数量、功能的改变,初步探讨PI-FD的可能发生机制。方法：纳入35例PI-FD患者、30例非PI-FD患者和20名健康志愿者。35例PI-FD患者中,14例粪便培养致病菌阳性（PI-FD-A组）,21例粪便培养阴性,根据临床表现确诊（PI-FD-B组）。以5-羟色胺（5-HT）免疫组化染色计数胃黏膜EC细胞,高效液相色谱电化学法检测胃黏膜5-HT浓度,透射电子显微镜观察EC细胞超微结构及其与神经纤维的毗邻关系。结果：PI-FD组胃黏膜EC细胞数和5-HT浓度显著高于非PI-FD组和健康对照组（P〈0.05）,且EC细胞数量与黏膜炎症程度呈正相关（P〈0.05）。电子显微镜下,EC细胞内细胞器较多,部分胞质内可见特异性分泌颗粒,PI-FD组距神经纤维5μm范围内EC细胞数显著高于非PI-FD组和健康对照组（P〈0.05）。PI-FD-A组与PI-FD-B组的EC细胞数量和5-HT浓度均无明显差异。结论：PI-FD患者胃黏膜EC细胞显著增殖、活化,EC细胞激活途径可能在PI-FD的发病过程中起重要作用。     

符合罗马Ⅲ标准的功能性消化不良患者固体胃排空功能研究

背景：罗马Ⅲ标准对功能性消化不良（FD）的定义作了更新和修订，相应FD患者人群亦发生改变。目的：研究符合罗马Ⅲ标准的FD患者的固体胃排空功能，以及新的FD症状谱和分型与固体胃排空功能之间的关系。方法：对36例符合罗马Ⅲ标准的FD患者和32名健康志愿者行^99Tc固体胃排空试验。比较不同症状分型FD患者的固体胃排空功能，分析固体胃排空功能与罗马Ⅲ标准中FD症状的相关性。结果：10例（27．8％）FD患者固体胃半排空时间超过正常上限，9例（25．0％）2h残留率高于正常上限。餐后不适综合征（PDS）、上腹痛综合征（EPS）和PDS＋EPS型FD患者固体胃半排空时间分别为（150．3±40．2）min、（118．3±25．1）min和（150．5±51．2）min，三组间差异无统计学意义（P=0．126）。餐后饱胀不适症状与固体胃半排空时间和2h残留率均呈线性正相关．相关系数分别为11．5（P=0．043）和0．045（P=0．040）。结论：本组27．8％的FD患者存在固体胃排空延迟。PDS和PDS＋EPS型FD的固体胃半排空时间有长于EPS的趋势。FD患者的餐后饱胀不适症状与固体胃排空延迟有关，固体胃排空延迟是符合罗马Ⅲ标准的FD患者的病理生理机制之一。     

Gastric Myoelectrical Activity in Healthy Children and Children with Functional Dyspepsia

The aim of this study was to investigateabnormalities in pediatric patients with functionaldyspepsia. Fifteen symptomatic pediatric patientsdiagnosed with functional dyspepsia and 17 aged-matchedhealthy controls were studied. Gastric myoelectricalactivity was recorded using surface electrogastrographyfor 1 hr in the fasting state and 1 hr after a testmeal. It was found that, in comparison with thecontrols, the children with functional dyspepsia had alower percentage of 2- to 4-cpm slow waves in bothfasting state (66.0 ± 4.7% vs 79.7 ± 3.1%,P < 0.07) and fed state (72.4 ± 5.4% vs 85.0± 2.9%, P < 0.04), and a significantly higherinstability of the dominant frequency in both fastingstate (0.50 ± 0.05 vs 0.31 ± 0.04, P <0.01) and fed state (0.39 ± 0.05 vs 0.25 ±0.03, P < 0.05). It was also found the postprandial increase inEGG dominant power in the patients was inverselycorrelated with the total symptom score (r = 0.63, P =0.03). It was concluded that abnormal gastricmyoelectrical activity may play a role in the pathogenesis ofpediatric functional dyspepsia.     

胃起搏对胃动力紊乱犬胃肌电活动和血浆胃动素水平的影响

背景:胃起搏治疗胃动力紊乱性疾病已引起人们的关注,但其作用机制尚不清楚。目的:研究胃起搏对胃动力紊乱犬胃肌电活动和血浆胃动素水平的影响,观察胃起搏治疗前后胃电参数与血浆胃动素含量的相关性,进而探索胃起搏的作用机制。方法:采用双侧迷走神经干切断术联合应用胰高血搪素建立胃动力紊乱或节律紊乱犬模型。采用4导联胃肠电系统微机分析仪记录胃浆膜肌电活动:采用放射免疫法测定血浆胃动素含量。采用适宜的起搏参数从腹部体表驱动胃电慢波,1次d,每次45min,疗程为30天,均在餐后进行。结果:双侧逃走神经干切断术后,模型犬的餐后胃电主频(4.85 cpm±0.40 cpm)、平均幅度(2.32 mV±0.35 mV)和慢波传播速度(4.06 cm/s±0.40cm/s)均较止常对照犬显著降低(5.37 cpm±0.36 cpm,4.25 mV±0.12 mV.6.92 cm/s±0.24 cm/s,P<0.03),其术后血浆胃动素含量(242.09 pg/ml±17.22 pg/m1)显著高于术前(184.29 pg/ml±9.81 pg ml,P<0.01),且胃电主频、平均幅度和慢波传播速度与胃动素含量呈负相关(P<0.04)。经胃起搏治疗后,模型犬的餐后胃电主频(5.49cpm±0.31 cpm)、平均幅度(3.97mV±0.19mV)和慢波传播速度(5.57 cm/s±0.48 cm/s)均显著高于治疗前(P<0.05),血浆胃动素含量(212.55 pg/ml±11.20 pg/ml)则显著降低(P<0     

Electrogastrography Before and After a High-Caloric,Liquid Test Meal in Healthy Volunteers and Patients with Severe Functional Dyspepsia

Background: The cutaneous recording of gastric electric rhythm, so-called electrogastrography (EGG), has been purported as a non-invasive method for studying patients with functional dyspepsia and unexplained nausea and vomiting. The aims of this study were to determine normal values for EGG characteristics before and after a liquid, high-caloric test meal and to investigate whether EGG could discriminate between patients with functional dyspepsia and normal controls. Methods: In studying 20 healthy volunteers and 10 patients with functional dyspepsia, we recorded gastric electrical activity during the 30 min before and after a liquid 1.0-1.5 kcal/ml test meal. Satiety before and after the meal was estimated on a 10-point scale. EGG was analysed regarding dominant frequency, instability of the dominant frequency, power ratio and percentage activity in the normal frequency range. Results: The mean ( ± s ) caloric intake in patients with functional dyspepsia (286 ± 160 kcal) was significantly lower ( P < 0.001) than in healthy volunteers (610 ± 211 kcal). The patients reported a more pronounced feeling of satiety before the test meal (5.6 ± 3.2) compared to healthy volunteers (3.6 ± 1.2, P < 0.05), but at the end of the test meal there was no difference in satiety (7.9 ± 2.5 versus 7.7 ± 1.0). However, none of the EGG parameters showed any difference between patients and healthy volunteers. Conclusions: EGG before and after a high-caloric test meal showed large variation in healthy subjects and seemed to be of little value for differentiating between healthy individuals and patients with functional dyspepsia.     

功能性消化不良患者的胃液体排空和胃感觉阈异常

目的检测功能性消化不良(FD)患者的胃液体排空和胃感觉阈,以了解两者之间的联系.方法采用超声法测定68例FD患者和29例正常对照者饮水500ml后的胃体-底前后径变化,以了解胃液体排空情况;同时记录受检者摄入温水后出现上腹不适感觉时的饮水量以表示胃最小感觉容量(感觉阈).结果FD患者的胃液体半排空时间较正常人明显延迟(FD患者31.06min±10.29min,正常人24.63min±4.86min,P<0.001),胃感觉阈显著下降(FD患者412.50ml±94.47ml,正常人478.33m1±35.78m1,P<0.001),50%(34/68)的患者胃感觉过敏.胃感觉阈与胃液体半排空时间的相关分析表明,胃感觉阈越低,排空延迟越明显(P<0.05).结论FD患者不但存在胃排空延迟,还存在胃感觉过敏,两者有一定的相关性.     

Evaluation of Gastric Emptying Measured with the 13 C-octanoic Acid Breath Test in Patients with Functional Dyspepsia: Comparison with Ultrasonography

Background: As a non-invasive modality by which to evaluate the gastric emptying of a solid meal, the 13C-octanoic acid breath test has recently become more widely used. Previously, we reported that ultrasonography was another non-invasive and reliable method for assessing gastric motility. The aim of this study was to compare the reliability of these two methods. Methods: Seventeen patients with functional dyspepsia and 10 healthy volunteers were studied. The solid test meal consisted of a scrambled egg labeled with 13 C-octanoic acid (100 mg) and served with a bowl of rice and boiled chicken (total 424 kcal). After ingestion of the test meal, all subjects were examined in the sitting position. Ultrasonography images were obtained every 15 min for 3 h. Breath sampling followed the same time schedule as for the ultrasonography, with an additional 3 h of sampling at 30-min intervals. We investigated the half emptying time (T1/2) and the lag phase with both methods. Results: The T1/2 by the ultrasonography method and the breath test were positively correlated ( r 2 = 0.638); however, there was no significant agreement between the study groups. Both the T1/2 and the lag phase were prolonged in the functional dyspepsia patients compared with the healthy volunteers, regardless of the method of measurement. The lag phase was significantly correlated ( r 2 = 0.864) with the T1/2 by the breath test. Conclusions: Although the 13 C-octanoic acid breath test cannot assess the gastric emptying of solids as reliably as ultrasonography, both tests are useful for evaluating functional dyspepsia patients with delayed gastric emptying.     

功能性消化不良患者近端胃容受性的研究

背景:功能性消化不良(FD)患者的近端胃容受性日益受到重视。目的:研究FD患者的近端胃容受性。方法:22例FD患者和20名健康对照者以内脏刺激器/电子气压泵检测近端胃容受性,并进行早饱试验。结果:FD患者的近端胃容受性为278.2ml±95.3ml,显著低于健康对照者的394.7ml±83.5ml(P<0.05),45.5％的FD患者存在近端胃容受性障碍;FD患者的近端胃容受性障碍与早饱症状有关(OR:11.11;95％ CI:1.53～76.92;P=0.013);早饱试验的检测结果与近端胃容受性正常与否无关(P=1.0)。结论:近端胃容受性障碍可能是FD患者重要的病理生理异常,并可能与早饱症状的产生有关,尚不能用早饱试验来预测近端胃容受性障碍。     

Gastric Dysrhythmias and Delayed Gastric Emptying in Patients with Functional Dyspepsia

An association between dyspepsia, gastricmotility disorders, and myoelectrical abnormalities hasbeen noted. The objective of the present study was toinvestigate both antral myoelectrical activity and gastric emptying in patients with functionaldyspepsia (FD). Electrogastrography (EGG) was performedin 25 adult patients with FD, which had been evaluatedby score. After an overnight fast, for 1 hr in the pre- and postprandial state (370 kcalliquid-solid test meal) the following EGG parameterswere determined: dominant frequency [DF (cpm)], DF (%)in the normal range (2-4 cpm), bradygastria (<2 cpm), tachygastria (4-10 cpm), dominant frequencyinstability coefficient (DFIC), and postprandial tofasting power ratio (PR). The data were correlated toresults obtained in 20 age- and gender-matched controls. In addition, in 17 consecutive patients the EGGdata were compared to the gastric retention ofradionuclides after 60 min (liquid-solid phase labeledwith ^99mTc colloid). Patients with FDrevealed a preprandial increase in tachygastria compared to controls(P < 0.001). Of 17 FD, seven patients exhibiteddelayed gastric emptying (t60 retention >68%). Thesepatients showed significantly more pre- and postprandial tachygastrias than patients with normal gastricemptying (P < 0.05). The dyspeptic symptology and H.pylori status did not correlate with EGG andradioscintigraphy. Patients with FD frequently revealimpaired gastric emptying and increased tachygastria,which may have pathophysiological significance in someof these patients.