功能性消化不良患者胃机械感觉过敏

Mechanical Gastric Hyperaesthesia of Patients with Functional Dyspepsia

背景:功能性消化不良(FD)是临床上常见的症候群,其发病机制目前尚未完全阐明,现逐步认识到胃感觉过敏可能在FD的发病中起着重要作用。目的:探讨FD患者是否存在胃机械感觉过敏,同时了解胃顺应性变化。方法:应用电子恒压器对52例FD患者和15名健康对照者进行检查,采用恒压梯度扩张法扩张近端胃,获得胃机械扩张感知、不适、疼痛的压力和容积阈值,计算近端胃顺应性。结果:FD患者与健康对照者相比最小扩张压(MDP)无显著性差异;FD患者对胃机械扩张刺激的感知阈值、不适阈值、疼痛压力阈值均较健康对照者显著下降,40.4%的患者胃感知感觉过敏,46.2%的患者胃不适感觉过敏,51.9%的患者胃疼痛感觉过敏;FD患者胃感知和疼痛容积阈值较健康对照者显著降低。FD患者近端胃顺应性与健康对照组相比无显著性差异(P>0.05)。胃机械感觉压力阈值与近端胃顺应性无关。结论:部分FD患者中存在着胃机械感觉过敏,近端胃顺应性正常。

Background： Functional dyspepsia （FD） is very common in clinical practice, its pathogenesis has not yet been completely clarified, of which gastric hypersensitivity may play an important role. Aims： To appraise whether it exists mechanical gastric hyperaesthesia in FD patients and to learn concomitantly any change in gastric compliance. Methods： Gastric sensation threshold was examined by gastric barostat in 52 FD patients and 15 healthy controls. The proximal stomach has distended by constant pressure gradient distension, to obtain the pressure thresholds and volume thresholds of perception, discomfort and pain sensation, and to calculate the gastric compliance. Results： The minimal distending pressure （MDP） was not significantly different between FD patients and healthy controls. Gastric sensation pressure threshold （perception, discomfort, pain threshold） were significantly lower in FD patients than that in the healthy controls. 40.4% patients had gastric hypersensitivity of perception, 46.2% patients had gastric hypersensitivity of discomfort, and 51.9% patients had gastric hypersensitivity of pain. The volume thresholds of perception and pal,1 were significantly lower than those of the healthy controls. Gastric compliance was not significantly different between FD patients and healthy controls. Mechanical gastric sensation threshold was not relevant with gastric compliance. Conclusions： Mechanical gastric hyperaesthesla is present in a portion of FD patients, whereas the proximal gastric compliance is normal in FD patients.