甲状腺功能亢进患者的消化道功能异常及体表胃肠电动态频谱改变

104例甲亢临床资料显示,胃肠道症状(多食易饥69％、食后腹胀38％,恶心呕吐19％、大便改变67％)的出现率颇高。23例患者及70名对照组健康人检测体表胃、结肠电,2,232序列频谱分析结果显示:1.甲亢患者,尤其有恶心、呕吐、返酸症状者,其空腹活跃期胃电活动指数倾向或明显高于正常,提示空腹胃运动亢进;2.有食后腹胀或更兼有纳差的甲亢患者,其餐后10～20min内胃电活动量达到最大值的百分例数及活动指数低于正常,进餐反应延缓并减弱;3.腹泻或便烂的甲亢患者,其各段结肠低、高频段的肠电活动量均较健康人大便软条者明显降低,提示①结肠平滑肌张力减低、腔内压降低,可致内容物肛向移动阻力减小;②起挤压搅拌作用的局限性运动减弱,与大便不成形关系密切;4.便烂兼有肠激惹征的甲亢患者,其空腹升、降结肠肠电异常活跃,餐后降结肠肠电活动亢进,与激惹性大使改变有关;5.便硬兼有肠激惹征的甲亢患者,空腹升、降、乙状结肠安静期低频段肠电活动量高于正常,提示起挤压搅拌、促进水分吸收的结肠活动增加,而餐后升结肠的肠电活动量异常增高,则可能是对硬便的代偿性反应。上述结果能解释甲亢患者有关胃肠道症状的某些发生机制。

Disorders of Gastroenteric Functions of Hyperthyroidism patients and Their Changes of Electrogastrocolonogram Running Spectrum

A hundred and four cases of patients with hyperthyroidism were observed. It was showed that the incidence of polyorexia was 69%, flatulence due to indigestion 38%, nausea and/or vomiting 19%, and stool changes 67%; indicating that changes of gastroenteric functions are important for the pathophysiologic progress of hyperthyroidism. Electrogastrocolonogram(EGCOG) of 23 cases and 70 controls (healthy adults) were examined. EGCOGs were analysed by Fast Fourier Transform and running spectrum. The results showed that there were different types of EGCOGs running spectrum changes of hyperthyroidism patients, and these changes were related to the different gastroenteric syndromes of the patients.