水负荷试验联合B超在评价功能性消化不良近端胃功能障碍中的地位

Role of water load test combined with ultrasound in the proximal stomach dysfunction of functional dyspepsia

目的 观察健康人(HS)和功能性消化不良患者 (FD)的水负荷试验结果,并结合B超对近端胃容积进行实时测量,以观察B超水负荷试验在评价近端胃功能中的地位。方法 共纳入 60名健康人和 40例确诊FD患者,并按照是否存在明显的早饱症状将FD患者分为早饱组和非早饱组。所有受试者均重复进行水负荷试验,观察指标包括阈值饮水量 (TV)、饱足饮水量 (SV)、阈值近端胃容积(TPSV)和饱足近端胃容积(SPSV)。结果 HS组 2次检查的各观察指标差异无统计学意义。TV和SV分别为(449. 0±15. 5)ml和(1028. 0±47. 0)ml,TPSV和SPSV分别为(154. 0±8. 2)cm3 无统计学意义和(399. 0±27. 7)cm3。SV TV和SPSV TPSV存在显著相关性(r=0. 82, P<0. 001)。FD组 2次检查的各观察指标差异无统计学意义。TV和SV分别为 (464±132)ml和 (870±216)ml。HS组和FD组试验结果差异无统计学意义。但FD早饱组和非早饱组的SV和TV差异有统计学意义 [ (分别为 (372±77)ml比(525±126)ml和(700±120)ml比(998±180)ml, P<0. 01]。HS组和FD早饱组在SV和TV上差异亦有统计学意义(P<0. 01)。结论 水负荷试验具有良好的可重复性。健康人和FD早饱组的水负荷试验结果差异有统计学意义,提示早饱症状可能与近端胃功能紊乱有关,同时也说明B超水负荷试验在评价?

Objective To investigate the water load test(WLT) results in healthy subject (HS) and functional dyspepsia (FD) patients, and evaluate the role of WLT with B-ultrasound (BUS) in the proximal stomach dysfunction of FD. Methods Sixty HS and forty FD patients (divided into early-satiety and non early-satiety subgroup) received WLT and BUS in the same condition. The study was repeated on a separate day at least 1 week apart. The WLT was performed based on the following protocol: each HS fasted for at least 8 hours, then drank 37 ℃ pure water in a 100ml per 20 seconds manner until satiety. With BUS, we could obtain the proximal stomach volume at the time when patients started feeling satiety (threshold) and got full (satiety). Parameters to assess drinking capacity included threshold volume (TV), satiety volume (SV), threshold proximal stomach volume (TPSV) and satiety proximal stomach volume (SPSV). Results There was no significant difference of parameters between two times of tests. In HS, TV and ST were (449±15.70) ml and (1027.69±47.32) ml respectively, TPSV and SPSV were (154±8.4) cm^3 and (399±28.2) cm^3 respectively. There was significant correlation between SV-TV and SPSV-TPSV (r=0.82, P<0.001). In FD patients, TV and ST were (463±132.0) ml and (879±215.4) ml respectively. There was no significant difference between HS and FD groups. But there was difference on TV and SV between early-satiety and non early-satiety subgroups[(372±77) ml vs (525±126) ml,and (700±120) ml vs (998±180), P<0.01, respectively], and there was difference between HS and early-satiety subgroups of FD. Conclusions The WLT may show good reproducibility. The significant difference of WLT results between HS and early-satiety subgroups of FD implied that early satiety may be related to proximal stomach dysfunction, and it may also indicate the important role of WLT with BUS in FD with proximal stomach function.