Electrogastrography in children and adolescents with type 1 diabetes: weak correlation with metabolic control parameters

AIM: To evaluate gastric myoelectrical activity with respect to duration and metabolic control of type 1 diabetes mellitus (T1DM). METHODS: 172 children and adolescents with T1DM (mean 14.4+/-3.7 y), divided into subgroups depending on diabetes duration (< 5 and > 5 y), and 35 healthy controls (mean 13.93+/-3.59 y) were examined. All subjects underwent electrogastrography (EGG) performed after overnight fasting. In subjects with T1DM, haemoglobin A1c (HbA1c) and blood glucose levels during EGG records were measured. RESULTS: 15.69% of T1DM patients and 91.42% of the controls fulfilled normal EGG criteria (p < 0.001). T1DM subjects had a lower percentage of fasting normogastria (34.56+/-27.35% vs 69.84+/-18.16%, p = 0.0001) and higher bradygastria (51.97+/-30.24% vs 19.11+/-15.01%, p = 0.0001) compared to controls. In diabetic patients, an increase in postprandial normogastria (60.37+/-23.96% vs 76.68+/-12.38, p < 0.05) and a decrease in bradygastria percentage (25.67+/-21.01% vs 9.58+/-7.13%, p < 0.05) was observed. In children with disease < 5 y, diabetes duration correlated with power ratio (r = - 0.27, p = 0.01), postprandial normogastria (r = - 0.24, p = 0.03) and tachygastria (r = 0.25, p = 0.02). Weak correlations between EGG parameters and glucose (preprandial dominant frequency r = - 0.19, p < 0.05; postprandial normogastria r = 0.23, p < 0.01) and HbA1c levels (preprandial bradygastria r = 0.19, postprandial dominant power r = 0.23; p < 0.05) were observed. CONCLUSION: Gastric myoelectrical rhythm derangement is present in a large proportion of young diabetic patients. Bradygastria is the most prominent EGG abnormality. Weak correlation was found between EGG parameters and diabetes metabolic control.     

胃癌患者胃电变化与胃排空的相关性研究

目的 通过胃电图和胃排空检测,了解胃癌患者胃电变化与胃排空之闻有无相关性.方法 对27例胃癌患者(胃癌组)和20例健康者(对照组)同时进行胃电图和胃排空检测.结果 ①胃癌组主功率和胃动过速百分比均高于对照组,正常慢波节律百分比低于对照组.②正常对照者中胃排空正常率75.0%(15/20);胃癌患者中胃排空正常率33.3%(19/27)(P=0.007).胃排空延迟的胃癌患者中,胃电图异常率83.3%(15/18);胃电图异常者中胃动过速73.3%(11/15);胃动过缓26.7%(4/15).胃排空正常的胃癌患者中胃电图异常33.3%(3/9),均为胃动过速.③胃癌组餐前后正常慢波节律百分比与4小时胃排空率之间呈正相关(P＜0.05),胃动过速百分比与4小时胃排空率之间呈负相关(P＜0.05).结论 胃癌患者存在胃电节律紊乱.主要表现为正常慢波节律百分比下降,主功率和胃动过速百分比升高.胃癌组餐前后正常慢波节律百分比与4小时胃排空率之间呈正相关,胃动过速百分比与4小时胃排空率之间呈负相关.     

Characterization of Gastric Myoelectrical Rhythms in Patients with Systemic Sclerosis Using Multichannel Surface Electrogastrography

The aim of this study was to characterize multichannel surface electrogastrography (EGG) recordings in patients with systemic sclerosis (scleroderma, SSc) compared to normal controls. Ten SSc patients and 13 healthy age-matched controls were enrolled in this study. Gastric myoelectrical activity was recorded using a four-channel electrogastrograph with abdominal surface electrodes. The EGG was recorded in the morning for 1 hr in the fasting state, and 1 hr after a standardized (500 kcal) test meal. It was found that: (1) The regularity of the gastric slow wave was significantly lower in the SSc patients when compared with the normal controls in both fasting and fed states. (2) There was a significantly higher incidence of bradygastria in the SSc patients. (3) The SSc patients showed a significantly lower percentage of slow wave coupling among the four-channel EGGs than the controls. (4) In comparison with the controls, the patients showed an impaired spatial distribution of gastric slow wave power in both fasting and fed states and an impaired spatial distribution of slow wave frequency in the fasting state. It was concluded that SSc patients have an abnormal gastric slow wave as shown in the multichannel EGG as a decreased percentage of normal slow waves and impaired spatial coordination of gastric slow waves. The multichannel EGG may serve as a simple, noninvasive, and cost-effective method to assess gastric motility disorders and their relevance in patients with SSc.     

Inhibitory reflexive effect of rectal distension on postprandial gastric myoelectrical activity

The aim of the study was to determine the effects of low-volume rectal distension on gastric myoelectrical activity. The study was performed in 14 healthy volunteers in 2 randomized sessions. In the control session, a small balloon was inserted into the rectum 10 cm beyond the anal verge and inflated with 20 ml of air. Gastric myoelectrical activity was recorded for 30 minutes in the fasting state and 30 minutes after a meal; and then the balloon was deflated and removed, and another 30-min recording was followed. The study session was the same except that after the 30-min baseline recording the balloon was inflated to reach a volume with which the subject felt an urgency for defecation. Spectral analyses were performed to compute the dominant frequency, power, and regularity (2–4 cycles/minutes, cpm) of the gastric slow waves and the percentage of gastric dysrhythmia. Results: 1). In comparison with our previously published data, the placement of the rectal balloon with a volume of 20 ml air did not affect the regularity of the slow waves (84.2 ± 3.6% in fasting, 85.3 ± 4.3% in fed); In comparison with the control session, the rectal distension inducing an urgency for defecation (average volume of air: 72.5 ml) significantly reduced the regularity of gastric slow waves in the fed state (72.0 ± 5.7%, P < 0.03 vs baseline; P < 0.02, vs control session) but not in the fasting state (80.1 ± 4.5%, P = 0.1). This postprandial change was attributed to a significant increase in bradygastria (3.1 ± 1.0% vs 7.9 ± 2.6%, P < 0.04) and a marginal increase in tachygastria (7.4 ± 2.5% vs 15.8 ± 4.3%, P = 0.06). The normal postprandial increases in the dominant frequency and power of the gastric slow wave were abolished in both sessions. conclusions, rectal distension evoking an urgency for defecation impairs postprandial gastric slow waves with an increase in the percentage of both bradygastria and tachygastria.     

An improved electrogastrographic system in measuring myoelectrical parameters

This study assessed the reliability of an improved electrogastrographic (EGG) system in recording stomach myoelectrical parameters and tried to establish the normal ranges of myoelectricity using this system. The analytical software of the current system mainly included an autoregressive modelling program to compute myoelectrical frequency and power. Forty healthy subjects were enrolled to receive myoelectrical measurement in two consecutively fasting and one postprandial 30 min sessions. The myoelectrical frequencies in both fasting and postprandial sessions were almost three cycles per min (c.p.m.) and showed little variation. The percentage of dominant frequencies (2.5–3.5 c.p.m.) in three sessions was approximately 80% while the computed myoelectrical powers in the first and second fasting sessions exhibited a significant correlation ( r = 0.84, P < 0.001). Meal ingestion increased the myoelectrical powers by 6.8 dB compared with the second fasting recording ( P < 0.001). The mean variation in myoelectrical amplitude for the ratio of second: first fasting session was 110.3 ± 88.8% (16–478%, median 88%). This new EGG system is, indeed, reliable for measuring myoelectrical frequency and power, whereas the interassay of recorded amplitudes appears markedly variable.     

胃电起搏治疗胃动力障碍疗效观察

目的: 通过观察胃动力障碍患者胃电起搏治疗前后症状及胃电节律变化情况,以评估胃电起搏治疗的疗效。方法: 对13例胃动力障碍患者行胃电起搏治疗,治疗前后进行症状评估及胃电图测定。结果: 13例胃动力障碍患者有明显的餐前餐后胃电节律紊乱,经胃电起搏治疗后症状有显著改善,总有效率为90.05%;治疗前后餐前正常慢波节律分别为(41.9±16.9)%和(46.9±21.6)%(P>0.05),治疗前后餐后正常慢波节律百分比分别为(57.5±28.6)%和(78.7±16.6)%(P<0.05)。结论: 胃电起搏治疗短期内能改善胃动力障碍患者的症状和胃电节律紊乱。     

替加色罗片对慢性便秘患者的消化不良症状、胃电活动、胃肠传输和肛管直肠功能的影响

目的:研究口服替加色罗对慢性便秘患者伴随的消化不良症状、胃电活动、胃肠传输和肛管直肠功能的影响。方法:43例慢性便秘患者进行口服4周替加色罗6mg每日两次或安慰剂随机双盲治疗。治疗前后用消化不良症状问卷、不透X线标记物法、胃电图和直肠肛管测压法评估患者消化不良症状、胃电活动、胃肠传输和肛管直肠功能的变化。结果:与安慰剂组相比,替加色罗组慢性便秘患者伴随的消化不良症状总积分治疗后较治疗前显著降低(11.57±3.24vs5.29±1.18,P=0.024)。替加色罗组治疗后空腹-餐后胃电正常节律百分比变化较治疗前显著减小(6.58%±1.29%vs11.80%±3.85%,P=0.044)。替加色罗组患者胃内残余钡条数较治疗前显著减少(5.95±1.65vs4.57±1.65,P=0.036);结肠内残余标记物数量(7.50±2.02vs5.89±1.94,P=0.029)较治疗前显著减少,其中右半结肠(1.06±0.50vs0.67±0.23,P=0.035)和直肠乙状结肠(3.33±1.28vs1.50±1.01,P=0.017)残余标记物数显著减少。替加色罗治疗后直肠排便窘迫阈值[(25.2±1.8)mmHgvs(22.9±2.0)mmHg,P=0.028,1mmHg=0.133kPa]和最大容量感觉阈值[(32.1±2.5)mmHgvs(29.3±2.3)mmHg,P=0.043]显著降低。替加色罗治疗后初次排便感觉阈值和肛管直肠压力较治疗前无统计学差异(P>0.05)。结论:替加色罗能改善慢性便秘患者的消化不良症状,改善餐后胃电活动,加速胃肠传输,降低直肠感觉阈值,提高直肠敏感性。     

肝硬化患者空腹胃动力障碍的临床研究

目的 :探讨肝硬化患者胃动力障碍发生率及其与肝功能的关系。方法 :运用体表胃电图观察 58例肝硬化患者和 2 2例健康人空腹胃肌电活动情况 ,观察指标包括平均振幅 ( AP)、平均过零频率 ( FZ)、中心频率 ( FC)、主频 ( FP)以及频谱形态。结果 :肝硬化患者胃电节律紊乱率明显高于健康组 ,其中 FZ分别为 38%和 50 % ;FP分别为 57%和 50 % ;Child- Pugh A组胃窦电节律紊乱率在 FP、FZ分别为 4 0 %和 2 0 % ;Child- Pugh B组分别为 61%和 32 % ;而 Child- Pugh C组则 10 0 %有胃窦节律异常。结论 :肝硬化患者电节律紊乱率较正常人明显升高 ,肝功能对胃电节律有影响     

小儿慢性胃炎体表胃电图检测

目的　通过体表胃电图描记了解小儿慢性胃炎胃肌电活动规律。方法　对 30例小儿慢性胃炎和 2 0例正常健康儿童进行餐前、餐后体表胃电图描记。结果　观察组较对照组餐后正常慢波百分比显著下降 [(60 3 %± 1 5 8% )vs(71 6 %±1 2 0 % ) ,P <0 0 5) ] ,餐前、餐后正常慢波百分比≥ 65 %所占比例下降无统计学意义 (63 .6 %vs70 .0 % ,P >0 0 5 ;50 .0 %vs70 .0 % ,P >0 0 5) ,餐后节律过缓 (<2 4/min)比例升高 ,但无统计学意义 [(1 8.4 %± 7.2 % )vs(8.5 %± 5 .3 % ) ,P >0 0 5) ] ;实验组胃电图波形奇异、不规则复合波多见。结论　小儿慢性胃炎存在胃电节律改变 ,表现为餐后正常慢波百分比显著下降。胃电图可应用于小儿慢性胃炎的初筛检查     

新生儿胃电图与孕后年龄相关性的分析

目的 胃电图是应用表面电极进行经皮记录下的胃肌电活动情况。由于其具有非侵入性及与胃蠕动的相关性，而激起人们对胃电活动的兴趣，它对新生儿意义非同寻常。而新生儿胃电图资料不多且结果不一。本文欲探讨健康新生儿胃电活动与孕后年龄(胎龄 日龄)的相关性。方法 对23名健康早产儿住院期间每周记录1次胃电活动，19名足月儿分别进行1次胃电活动记录，共计61次。记录时间为餐前、餐后至少60分钟以及用餐时间。应用计算机化的胃电图参数进行分析，相关参数包括主频率(DF)，主频率在正常范围内的百分值(2～4CPM％)，主频率变异系数(DFIC)，餐后与餐前主频率能量比值(PR)。结果 我们未发现EGG参数值与孕后年龄的相关性。餐后2-4CPM％较餐前值显著下降(P=0．032)，餐后DF(P=0．26)，主频率能量(P=0．12)较餐前呈下降趋势，但是餐后DFIC较餐前有增加趋势。结论 在我们的研究中，通过胃电图我们没有发现胃电活动与孕后新生儿年龄的相关性。与其他资料结果相反，我们发现餐后DF，及主频率能量下降。即使胎龄小于35周的早产儿亦能产生胃电活动图形。总之，新生儿胃电图结果还存在许多矛盾之处，有待进一步探讨。