饮水负荷试验与电子恒压器法测定胃感觉功能的比较

目的建立简单易行、非侵入性、符合胃肠生理的检测胃感觉阈值的方法。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。了解饮水负荷试验测定胃感觉阈值的敏感性、特异性、符合率,以及二者之间有无相关性。结果与电子恒压器法(用容积表示感觉阈值)相比较,饮水负荷试验测定胃感知阈值和不适阈值的敏感性为76.9%和75%,特异性为100%和90.9%,符合率为93.3%和86.7%,两种方法所测定的结果具有良好的相关性(P值均<0.01)。与用电子恒压器测得的压力值表示的感觉阈值进行比较,饮水负荷试验测定胃感知和不适阈值的敏感性为85.7%和81.8%,特异性为93.5%和91.2%,二者的符合率为91.1%和88.9%,两种方法所测得的结果也具有良好的相关性(P值均<0.01)。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和符合率,以及良好的相关性,可作为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。

Comparison of water load test and barostat on the gastric sensation thresholds

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 (FD) patients by water load test and gastric barostat. Based on barostat, the sensitivity, specificity, coincidence rate of water load test were evaluated, and the correlation between two methods was assessed. Results Compared with gastric barostat based on the volume, the sensitivity, specificity, coincidence rate of water load test for evaluating perception and discomfort thresholds were reached 76.9% and 75.0%, 100% and 90.9%, 93.3% and 86.7%, respectively. Compared with gastric barostat based on the intragastric pressure, they were 85.7% and 81.8%, 93.5% and 91.2%,91.1% and 88.9% . There was a good correlation between water load test and gastric barostat (P < 0.01, respectively). Conclusions Water load test for evaluating the sensation threshold has higher specificity and coincidence rate as compared with gastric barostat. The water toad test can be applied effectively in clinical diagnosis for evaluating the sensory threshold.