功能性消化不良胃电图与胃排空检测的同步研究

Comparison between electrogastrogram and gastric emptying in patients with functional dyspepsia

目的 :通过胃电图与胃排空检测 ,研究功能性消化不良 (functionaldyspepsia,FD)的发病机制 .方法 :以FD患者为观察对象 ,依据罗马Ⅱ标准 ,将符合纳入标准的患者分为3个临床亚型 ,每型患者随机取 10人为一组 ,并以 10名健康志愿者作为对照组 ,分别做胃电图及胃排空检测 .胃排空检测后 ,再将 30例FD患者分为 2组 ,胃排空正常组和胃排空延迟组 .利用胃电图仪记录胃电变化 ,通过99Tcm 标记的固体餐检测胃排空 .结果 :① 30例FD患者中 ,胃排空延缓 18例 ,占6 0 .0 % ,其中 ,溃疡样型 4例 ,动力障碍样型 7例 ,非特异性型7例 .与健康对照组比较 ,胃电图餐后平均振幅降低 (P <0 .0 5 ) ,就餐前后平均振幅差减小 (P <0 .0 5 ) ,就餐前后平均频率、餐前平均振幅无显著性差异 (P >0 .0 5 ) ;②胃排空正常组胃电图 4 1.7%异常 ,各项指标与健康对照组、胃排空延迟组比较均无显著性差异 (P >0 .0 5 ) ;③FD胃排空延迟组胃电图 83.3%异常 ,就餐前后平均振幅差减小 (P <0 .0 5 ) ,餐后平均振幅降低 (P <0 .0 5 ) ,就餐前后平均频率、餐前平均振幅与健康对照组比较无显著性差异 (P >0 .0 5 ) .结论 :胃运动障碍是FD发病的重要病理生理机制 。

AIM: To study the pathogenesis of functional dyspepsia (FD) by electrogastrogram and gastric emptying test. METHODS: According to the RomeⅡcriteria, patients with FD were classified into 3 subclasses. From each subclass, 10 patients were randomly chosen in this study. 10 Healthy volunteers were used as normal control. All the patients and volunteers underwent electrogastrogram examination and gastric emptying test. Gastric emptying test was performed using 99 Tc m labelled solid food. Patients with FD were divided into 2 groups according to the results of gastric emptying test: normal gastric emptying group and delayed gastric emptying group. Data were collected accordingly and statistic analysis was performed. RESULTS: ① 18 patients showed gastric emptying delay. In patients with FD, post meal average amplitude (AP) and △AP reduced significantly ( P <0.05), compared with the control. However pre meal, post meal average frequency and pre meal AP did not show significant changes( P >0.05); ②In FD patients with normal gastric emptying, 41.7% showed abnormal electrogastrogram; ③ In the FD patients with delayed gastric emptying, 83.3% were abnormal in electrogastrogram and their post meal AP and △AP decreased significantly( P <0.05). However, pre meal and post meal average frequency, pre meal AP did not show significant changes( P >0.05). CONCLUSION: Motility disturbance of stomach plays an important role in the pathogenesis of FD. Electrogastrogram and gastric emptying test have a good consistency in determining FD.