饮水负荷试验测定胃感觉的临床研究

目的　建立简便易行、非侵入性、符合胃肠生理的检测胃感觉阈值的诊断方法。方法用饮水负荷试验和电子恒压器法分别对 15例健康自愿者和 30例功能性消化不良患者的胃感知和不适阈值进行测定 ,以了解饮水负荷试验测定胃感觉阈值的敏感性、特异性、Kappa值、符合率 ,以及二者之间有无相关性。结果　与电子恒压器法相比较 ,饮水负荷试验测定胃感知阈值的敏感性为85 7% ,特异性为 93 5 % ,Kappa值为 0 82 ,二者的符合率为 91 1% ,两种方法所测得的结果也具有良好的相关性 (P <0 0 1)。饮水负荷试验测定胃不适阈值的敏感性为 81 8% ,特异性为 91 2 % ,Kappa值为 0 79,二者的符合率为 88 9% ,两种方法所测得的结果也具有良好的相关性 (P <0 0 1)。结论　与电子恒压器相比 ,饮水负荷试验测定胃感觉阈值具有较高的特异性、Kappa值和符合率 ,以及良好的相关性 ,可用于消化不良患者胃感觉功能临床辅助诊断和初筛检查 ,在基层医院有广泛的应用前景。

The clinical study of water loading in gastric sensation thresholds testing

Objective To establish a simple,noninvasive,physiologic diagnostic assay for evaluating gastric sensation thresholds. Methods The gastric perception and discomfort thresholds were monitored in 15 healthy controls and 30 functional dyspepsia patients by water load test and gastric barostat. Based on barostat the sensitivity,specificity,Kappa value,coincidence rate of water load test were evaluated and the correlation between those two methods was assessed. Results Compared with gastric barostat,the sensitivity,specificity,Kappa value and coincidence rate of water load test for evaluating perception thresholds were reached 85.7% ,93.5% ,0.82,and 91.1% . These of water load test for evaluating discomfort thresholds were reached 81.8%,91.2%,0.79,and 88.9% compared with gastric barostat. The results were showed a good correlation between water load test and gastric barostat (P<0.01,respectively). Conclusions It had higher specificity,Kappa value and coincidence rate of water load test for evaluating the sensation threshold compared with gastric barostat. It can be applied effectively in clinical diagnosis for evaluating the sensory threshold.