不同类型功能性消化不良患者胃排空的超声观察与分析

目的 探索胃肠超声造影检查并计算胃排空率用于评估功能性消化不良（functional dyspepsia, FD）的价值。方法 选择我院就诊的FD患者128例，记为FD组并进一步分为上腹痛综合征（epigastric pain syndrome, EPS）亚组68例和餐后不适综合征（postprandial discomfort syndrome, PDS）亚组60例。同期选择健康成年人65例作对照组。测量所有研究对象禁食时、0min（试餐结束即刻）、30min、60min、90min、120min时全胃腔容积（TGCV）并计算胃排空率。治疗结束后再次检查并计算FD患者的胃排空率。分析不同临床类型以及不同严重程度FD患者胃排空超声观察结果。结果 餐后FD组和对照组TGCV均呈下降趋势，但相同时间段内对照组TGCV变化幅度明显大于FD组（均P<0.05）。FD组的胃排空率在30min、60min、90min和120min时均较对照组低，两组胃排空率均随着时间的增长而呈上升趋势，但每个时间点上FD组的胃排空率均低于对照组（均P<0.05）。治疗前EPS亚组患者120min胃排空率显著大于PDS亚组，轻度患者显著大于重度患者，治疗后PDS亚组患者显著大于EPS亚组，差异有统计学意义（均P<0.05），轻度患者与重度患者差异无统计学意义（P＞0.05）。结论 超声胃肠造影检查并计算TGCV和胃排空率是一种有效的诊断FD的方法。

Ultrasonic observation and analysis of gastric emptying in patients with different clinical subtypes of functional dyspepsia

Objective To explore the value of gastroenterographic contrast echocardiography and calculate gastric emptying rate for assessing functional dyspepsia (FD). Methods Totally 128 patients with FD who were admitted to our hospital were involved as FD group and further divided into epigastric pain syndrome (EPS) subgroup (n=68) and postprandial discomfort syndrome (PDS) subgroup (n=60). In the same period, 65 healthy adults were involved as the control group. The total gastric cavity volume (TGCV) and gastric emptying rate of all subjects were measured when fasting, 0 min (immediately after the end of the trial meal), 30 min, 60 min, 90 min, 120 min after trial meal. After the end of the treatment, the gastric emptying rate of the FD patient was checked again and calculated. The ultrasound findings of gastric emptying in patients with different clinical types and different severity of FD were analyzed. Results The postprandial TGCV of both FD group and control group showed a decreasing trend, but the change of TGCV in the control group was significantly larger than that of FD group (P<0.05). The gastric emptying rate in the FD group was lower than that in the control group at 30 min, 60 min, 90 min, and 120 min. The gastric emptying rate in both groups increased with time, but the gastric emptying rates in the FD group at each time point were lower than those in the control group (all P<0.05). The 120-minute gastric emptying rate of patients in the EPS subgroup before treatment was significantly greater than that in the PDS subgroup. The mild patients were significantly larger than those in the severe patients. After treatment, the PDS subgroup was significantly larger than the EPS subgroup. All the differences were statistically significant (all P<0.05). There was no significant difference between patients with mild and severe patients (P>0.05). Conclusion Ultrasound gastrointestinal angiography and calculation of TGCV and gastric emptying rate are effective methods for the diagnosis of FD.