近端胃功能与功能性消化不良症状的关系

Relationship between the functions of proximal stomach and functional dyspeptic symptoms

探讨近端胃的顺应性及感觉阈值与功能性消化不良 (functionaldyspepsia ,FD)患者消化不良症状发生间的关系。利用电子恒压器 (SVS/Barostat)对 2 2例FD患者及 8例健康志愿者 ,分别测出近端胃的顺应性、初始容积和压力及最大耐受容积和压力。FD组及对照组的顺应性分别为 (4 4. 4± 15.0 )mL/mmHg(1mmHg =133.32 2Pa)、(6 6.7± 7.7)mL/mmHg,2组的最大耐受容积分别是 (6 4 6. 6± 14 5.1)mL、(76 8.8± 4 7.0 )mL ,FD组的顺应性及最大耐受容积明显低于对照组 (P <0.0 5 )。按消化不良症状积分分成轻、中、重度 3组 ,中、重度组的顺应性 [(4 0 .8± 17.6 )mL/mmHg、(34.9± 12.4 )mL/mmHg]和最大耐受容积 [(6 30. 0± 92.3)mL、(5 87.5± 89.7mL) ]均低于轻度组 [(5 0.4± 35.4 )mL/mmHg、(70 5.8± 195.3)mL](P <0.0 5 )。按早饱症状积分分为轻、中、重度 3组 ,轻、中度组的初始容积 [(36 8.3±114.1)mL、(35 5.8± 6 3.8)mL]和最大耐受容积 [(5 90.0± 2 9.3)mL、(5 4 7.2± 87.9)mL]明显高于重度组 [(2 34.4±4 0.3)mL、(4 86. 7± 5 8.4 )mL](P <0.0 5 )。早饱积分、腹胀积分分别与初始容积 (r=- 0.6 35 6 ,P <0.0 1;r=- 0.4 192 ,P <0.0 5 )以及消化不良症状积分与顺应性 (r=- 0.35 6 1,P <0.0 5 )之?

To evaluate the compliance and visceral perceptive threshold of proximal stomach in the patients with functional dyspepsia (FD) and the relationship between the compliance and the causes of dyspepsia. The indexes of proximal stomach motor and sensory functions, were measured by SVS/barostat in 22 functional dyspeptics and 8 healthy volunteers. Results In comparison with control group [(66.7±7.7) mL/mmHg,(768.8±47.0)mL] ,the compliance and maximal tolerance volumes in FD group[(44.4±15.0) mL/mmHg, (646.6±145.1)mL] were lower(P<0.05). According to the degree of symptoms of dyspepsia and bloating, the patients were divided into 3 groups(mild, moderate and severe). The compliance in moderate group(34.9±12.4)mL/mmHg and severe group(40.8±17.6)mL/mmHg were lower than that of mild group of dyspepsia(50.4±25.4)mL/mmHg, respectively (P<0.05). As far as the satiety was concerned, the initial volumes and maximal tolerance volumes in severe[(234.4±40.3) mL, (486.7±58.4)mL] were smaller than mild[(368.3±114.1)mL,(590.0±29.3)mL] and moderate group [(355.8±63.8)mL, (547.2±87.9)mL](P<0.05). In additional, there was a correlation between satiety scores and the indexes as initial volume (r= -0.6356,P<0.01); so were between the bloating scores and initial volume(r=-0.4192,P<0.05), and the dyspeptic scores and compliance(r=-0.3561,P<0.05).The viscoelastic change in the proximal stomach wall may be one of the causes of FD and there was a correlation between visceral perceptive threshold in proximal stomach and the degrees of symptoms in FD, which illustrated that the changes of visceral perceptive threshold was involved in the appearance of symptoms of dyspepsia, especially of bloating.