幽门螺杆菌感染与功能性消化不良胃排空的关系

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０９４±１３９ｃｍ２、１３４±３１６ｃｍ２、９２３±１４０％和３５８±２３５％）与Ｈｐ阴性者（分别为１１９±２１２ｃｍ２、１２５±２７８２、９１２±１２２％和３２１％±２４０％）比较，无显著性差异（Ｐ＞００５）；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０７７±１４２ｃｍ２、１３２±３５ｃｍ２、１００±１２２％和３４７±２６０％）与非活动性胃炎患者（分别为１２８±２０７ｃｍ２、１２７±２５２ｃｍ２、９７４±１４５％和３３２±２４％）比较，也无显著性差异（Ｐ＞００５）。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     

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.     

幽门螺杆菌感染与功能性消化不良的关系

幽门螺杆菌(HP)感染是慢性胃炎和消化性溃疡的最主要病因,已得到国际医学界的首肯。但是功能性消化不良(FD)与HP感染的关系,目前争议较多,本文就此作一探讨。     

幽门螺杆菌感染与功能性消化不良

功能性消化不良(FD)是指有消化不良症状,但经检查排除了引起这些症状的器质性疾病,并在过去12个月中症状至少存在12周的症征。FD根据主要症状又可分为以疼痛为主的溃疡样(ulcer like)型、以上腹饱胀不适为主的动力障碍样(dysmotility like)型以及难以归入上述二型的非特异(unsp     

幽门螺杆菌与功能性消化不良的关系

功能性消化不良（FD）曾经被命名为非溃疡性消化不良（NUD）,是指具有由胃十二指肠功能紊乱引起的症状、经检查排除引起这些症状的器质性疾病的一组临床综合征。虽然研究认为FD的发生与胃肠动力障碍、内脏高敏感性、胃酸分泌、精神心理因素和幽门螺杆菌（Hp）感染等因素有关,但目前一系列针对FD的对症治疗手段反映了FD发病机制尚不确定,     

功能性消化不良的诊治进展

<正>临床上功能性消化不良(FD)的患者约占目前胃肠内科专科门诊的1/3,研究发现,FD的患病率与性别、年龄、种族、生活环境、家庭文化背景、经济情况均有相关性。而遗传易感性、食物药物、性格特征及目前较受关注的幽门螺杆菌也对其有一定影响〔1〕。难治性FD的疗效不佳以及反复发作问题也于近年受到重视,为患者反复就诊和医疗耗费增加的重要原因。异常饮食行为因素与青中年FD患者密切相关;过度关注幽门螺杆     

幽门螺杆菌与功能性消化不良

消化不良是指持续或反复发作的上腹痛或不适 ,包括不同程度和性质的上腹痛、上腹胀、早饱、嗳气、恶心等上腹部症状 ,病程超过 2周。功能性消化不良 (ＦＤ)是指有消化不良而经详尽的检查未能发现引起这些症状的局部或全身器质性病变[1] 。ＦＤ的病因及发病机制未明 ,目前认为是多种因素引起的临床综合征。自幽门螺杆菌 (Ｈｐ)发现以来 ,Ｈｐ与ＦＤ的关系便受到关注 ,因为ＦＤ患者中有30 %～ 6 0 %有Ｈｐ感染及由此而引起的慢性活动性胃炎。然而 ,十多年来大量的研究却一直未能为两者的关系提供明确的证据 :(1)不少调查表明 ,在ＦＤ患者中Ｈ…     

功能性消化不良中的幽门螺杆菌感染与精神心理因素

功能性消化不良(FD)是一类胃肠运动和内脏感觉异常性疾病,目前倾向于认为其是多因素所致的综合征。幽门螺杆菌感染可导致FD的形成;FD患者不同的表现可引起不同程度的精神心理改变,而精神心理疾病亦可引起FD。本文就FD中幽门螺杆菌感染与精神心理因素的研究进展作一综述。     

功能性消化不良与幽门螺杆菌感染的关系

功能性消化不良是临床上最常见的一种功能性胃肠病.目前,多种致病因素被认为与其有关.其中,幽门螺杆菌(Helicobacter pylori,H.pylori)感染与功能性消化不良之间的关系虽然已经得到了广泛的研究,但仍然没有得出确切一致的结论.近些年来,随着对功能性消化不良疾病认识的逐渐加深,且由于罗马标准的几经修改,较多先前的研究已经显现出自身的弊端,且各种观点相差甚远.本文旨在对功能性消化不良与H.pylori之间关系的研究及目前各方面的观点作一综述.     

功能性消化不良发病机理的研究进展

消化不良 (Ｄｙｓｐｅｐｓｉａ ,ＤＰ)一词来源于希腊语 ,指持续性或反复发作性的上腹部不适 ,还包括下列症状中的一项或数项 :餐后饱胀、腹痛胀气、嗳气、早饱、厌食、恶心、烧心、呕吐、胸骨后疼痛、反胃等。ＤＰ分为器质性和功能性两大类 ,器质性消化不良系由某些消化系统疾病 (如溃疡病、肝胆胰等疾病 ) ,或全身其它系统疾病和某些药物引起 ;另有相当一部分消化不良患者经多种检查排除器质性的改变 ,1984年 ,Ｔｈｏｍｐｓｏｎ将其概括为非溃疡性消化不良 (Ｎｏｎ ｕｌｃｅｒｄｙｓｐｅｐｓｉａ ,ＮＵＤ)并被广泛使用达 10年之久 ,其原意…     

功能性消化不良胆囊功能及其与胃排空相关性的初步探讨

为了解功能性消化不良(Functional dyspepsia.FD)患者是否存在胆囊功能障碍及胆囊功能与胃运动功能之间的相关性,我们对16例FD患者及8名健康人进行了B超下胆囊功能测定及核素胃排空检查.结果显示:FD患者2小时胃排空率为56.38±14.93%,半排空时间为104.72±22.73min,正常人胃排空率为70.75±11.44%,半排空时间为83.60±19.99min.FD组的胃排空明显延迟(P<0.001).FD组胆囊排空率<30%者较正常人明显增多(P<0.05),而将FD组进一步分为胃排空异常及胃排空正常组后发现胃排空正常的FD病人胆囊功能与健康人无差异,而胃排空延迟的FD病人的胆囊排空率亦明显降低,与正常人及胃排空正常的FD病人相比均有显著差异(P<0.05).结果表明功能性消化不良患者有胆囊排空功能的减弱,这种减弱与胃排空功能障碍有关,其相关的机制有待于进一步研究.     

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

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。     

The Risk Factors and Quality of Life in Patients with Overlapping Functional Dyspepsia or Peptic Ulcer Disease with Gastroesophageal Reflux Disease

Background/Aims

Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and peptic ulcer disease (PUD) impact the daily lives of affected individuals. The aim of this study was to compare the risk factors and impacts on life quality of overlapping FD or PUD in patients with GERD.

Methods

Data from patients diagnosed with GERD were collected between January and November 2009. FD was defined using the Rome III diagnostic criteria. The overlapping GERD-FD or GERD-PUD groups were classified as concomitant GERD and FD or peptic ulcers. The characteristics of these individuals were analyzed.

Results

There were 63, 48, and 60 patients in the GERD only, overlapping GERD-FD, and overlapping GERD-PUD groups, respectively. Significantly younger age, female gender, lower body weight and body mass index, and higher rates of tea consumption were noted in the GERD-FD group. Patients in the GERD-FD group exhibited the lowest quality of life scores, both with respect to physical and mental health, on the Short Form 36 domains.

Conclusions

Patients with concomitant GERD and FD were more likely to be younger and female. Overlapping GERD and FD had the worst impact on the quality of life of the affected individuals.     

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

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。     

Long-Term Follow-up Study of Gastric Emptying and Helicobacter pylori Eradication Among Patients with Functional Dyspepsia

Studies on the influence of Helicobacter pylori gastritis on gastric motility have produced inconclusive results. We investigated the effect of Helicobacter pylori eradication therapy on gastric emptying in patients with functional dyspepsia in a placebo-controlled double-blind study with one year follow-up. A standardized scintigraphic double-tracer examination was used. Of the 40 subjects, 29 were H. pylori-positive patients with functional dyspepsia and 11 were asymptomatic control subjects. Gastric emptying parameters were: postlag 50% retention time for solids (T50), gastric emptying half-time for liquids (T1/2), solid lag duration, and intragastric distribution of solids. At baseline, the scintigraphic examination was performed for all study subjects to detect any major alterations between dyspeptic patients and asymptomatic control subjects. Thereafter every patient was randomized to receive either H. pylori eradication therapy or placebo; in addition they also received omeprazole 20 mg once a day for three months to stabilize the acid suppression therapy. After one year scintigraphy was repeated for the patients. The solid lagtime was prolonged among dyspeptic patients compared with asymptomatic controls (P = 0.02). After one year there was no significant difference between H. pylori-eradicated and placebo-treated patients in any gastric emptying parameter. However, good reproducibility of the scintigraphic examination showing the gastric emptying rate of solids (r = 0.43, 95% CI: 0.07–0.69; P = 0.02) and liquids (r = 0.44, 95% CI: 0.09–0.69; P = 0.02) continued even after one year of follow-up. In conclusion, eradication of H. pylori has no impact on gastric emptying in patients with functional dyspepsia, but the long-term trend in individual gastric emptying rate is stable.     

功能性消化不良患者的心理评估分析

目的和方法:本篇以调查表的形式对91例功能性消化不良患者和79名健康者在性格、情绪、生活事件等方面进行了对照研究。结果:功能性消化不良患者神经质、焦虑、抑郁平均分值显著高于健康者;内外倾向平均分值显著低于健康者;生活事件变化单位值两组间无差异。结论:性格、情绪与功能性消化不良的发病有着密切关系,而生活事件与其关系尚不能确定。     

儿童功能性消化不良危险因素分析

目的 探讨儿童功能性消化不良(FD)的危险因素.方法 采取定群随机抽样的调查研究方法,首先采用问卷调查,筛选出有上消化道症状半年以上的患儿.从患者中随机抽取480例行胃镜检查及幽门螺杆菌(Hp)检测,排除器质性病变确定为FD者382例;以423名无症状健康儿童作为对照.用PEMS 3.1 for Windows统计软件进行分析.结果 济南市儿童FD患病率约为23.28%.按危险度高低,儿童FD的危险因素依次为:家庭不和睦、爱吃零食、CagA-IgG阳性、学习困难及有家族史.结论 FD在儿童发病率并不低,致病因素是以社会、心理因素为主的综合性因素,亦与Hp感染、饮食习惯等有关.     

Correlation of Gastric Liquid Emptying with Various Thresholds of Sensation in Healthy Controls and Patients with Functional Dyspepsia

Our objective was to investigate the correlation between gastric emptying and sensation in patients with functional dyspepsia (FD). Thirty patients with FD and 15 controls were studied. Proximal gastric compliance and sensation thresholds were measured with a barostat, and gastric emptying was assessed for 70 min after the ingestion of 500 ml of water using real-time ultrasonography. Results were as follows. (1) Patients showed a significantly longer half-time of gastric emptying than controls (30.03 +/- 8.20 vs. 23.07 +/- 4.67 min; P < 0.001). The sensation thresholds were significantly lower in patients than in controls based not only on pressure but on volume. However, there was no difference in gastric compliance between patients and controls. (2) The half-time of gastric emptying was correlated with various thresholds of sensation based on the volume (perception, r = -0.52, P < 0.005; discomfort, r = -0.54, P < 0.005; pain, r = -0.58, P < 0.005; maximal tolerance, r = -0.42, P < 0.005). But there was no significant correlation between gastric emptying and sensation thresholds based on pressure. Delayed gastric emptying and/or gastric hypersensitivity are present in more than 50% of FD patients. The coexistence of these two abnormalities is more common than the single impairment. There is a correlation between gastric emptying and visceral sensation to gastric distention in patients with FD.     

功能性消化不良患者胃动力障碍和症状之间的关系

目的 探讨功能性消化不良(FD)患者胃动力障碍与消化不良症状之间的关系.方法 应用核素法检测症状严重程度不同的FD患者的固体食物排空及餐后胃内食物分布情况,并设正常对照组20例进行比较.结果 症状轻微和症状严重的FD患者与对照组相比均存在胃排空时间的延长,但两组FD患者胃排空时间没有显著的差异;症状轻微的FD患者与对照...