功能性消化不良消化间期和消化期体表胃电变化规律

目的:观察正常人及消化不良病人消化间期和消化期EGG的动态变化规律及探讨餐后胃电与胃窦机械收缩之间的偶联关系。方法:采用PC Polygraph HR台式高分辨上消化道动力监测系统对11例正常人和14例功能性消化不良(FD)病人连续5小时同步记录体表胃电和胃窦幽门十二指肠压力变化。结果:正常人胃电功率随消化间期移行性复合运动(MMC)的周期变化而变化,Ⅱ期时增高,约为Ⅰ期的2倍,Ⅲ期最高,约为Ⅰ期的2.5倍,餐后功率与Ⅲ期接近,FD病人胃电功率只在餐后30分升高。消化间期胃电功率和胃窦动力指数呈正相关(正常组:r=0.87,P<0.01;FD组:r=0.79,P<0.01)。结论:体表胃电可以反映MMC周期性变化和胃窦运动功能。FD病人餐后胃电功率减低。

Relationship of EGG with Mechanical Contractions and its Response to Meal in Healthy Subjects and Patients with Functional Dyspepsia

Background/Aims: (1) To investigate the relationship between dynamic change of EGG with motility index of antrum during MMC cycle in healthy subjects and patients with functional dyspepsia, and (2) to verify whether a 100% coupling of electrical and mechanical events existed after meal. Methods: Eleven healthy subjects (HS) (7M, 4F, age 21-60 years, mean 34 years) and 14 patients with functional dyspepsia (FD) (7M, 7F, age 15-65 years, mean 41 years) were studied. An 8-channel Dent-sleeve catheter was positioned under fluoroscopic guidance across antropyloroduodenal region and bipolar electrodes were attached to the skin corresponding to the location of antrum. Antropyloroduodenal pressure waves and electrical signals were transferred simultaneously to PC Polygraph (CTD) and recorded for 3 hours preprandially and 2 hours after ingestion of 40g solid meal (80kcal). The power of EGG and motility index (MI) of antral contractions were calculated as the area under curve (AUC) by a build-in computer program. Results: The power of EGG increased significantly in phase II (P<0.01), phaseIII (P<0.01) and after meal (P<0.01) compared with phase I in HS, However, this dynamic increase was not found in FD. The power of EGG was positively correlated with the motility index of antrum both in HS (r=0.87, P<0.01) and in FD (r=0.79, P<0.01) during the interdigestive period. A significant increase of EGG power after meal was found in HS, which corresponded to the degree of phase ffl and kept stable for the whole postprandial period. In contrast, power increase was not found in FD except during 30 min after test meal. Conclusions: (1) Prolonged cutaneous EGG recording could reflect the periodic variation of MMC cycle. (2) EGG response in HS but not in FD after meal is characterized as persistent increase which is corresponded to phase III.