功能性消化不良患者的胃排空和胃内食物分布

Gastric emptying and intragastric food distribution in patients with functional dyspepsia

目的:探讨功能性消化不良(FD)患者的胃排空、胃内食物分布情况及其与消化不良症状之间的关系．方法:采用双核素标记试餐SPECT检测FD患者和正常对照组(HC)胃排空功能及胃内食物分布情况,并对60例FD患者的症状进行分级评分．结果:23例(38％)FD患者的固体及液体排空时间同时延迟,40例(67％)FD患者至少存在一项胃内固体食物分布参数异常,液体食物近端胃半排空时间较对照组延长,而在远端胃内的分布两组十分相似．胃排空正常和延迟的FD两组之间各症状积分相似,而在餐后胃内食物分布异常的FD组,恶心和早饱两种症状积分明显高于胃内食物分布正常的FD组．结论:部分FD患者存在胃排空和/或胃内食物分布异常,其中胃内食物分布异常与消化不良症状的严重程度之间存在一定的关系．

AIM： To assess gastric emptying and intragastric distribution of food in functional dyspepsia （FD） patients, and to investigate the relationship between dysmotility and severity of symptoms. METHODS： A standardized scintigraphic exarnination was performed on 60 FD patients and 27 healthy controls. Seven kinds of upper gastrointestinal symptoms were investigated using a standardized questionnaire and a score （from 0 to 3） was assigned according to the frequency and severity of symptoms. RESULTS： In comparison with controls, 23（38%） patients had abnormal gastric emptying. The number of patients with abnormal scintigraphic patterns increased to 40 （67%） when intragastric food distribution parameters were considered. Proximal gastric half-emptying time of solid and liquid was significantly delayed in patients with FD. Maximal solid fraction of the distal stomach was significantly increased, and the time of maximal fraction of the distal stomach was significantly delayed in FD patients. In contrast, maximal liquid fraction of the distal stomach was the same in patients as that in controls. The symptom scores were not different between the patients with normal and delayed gastric emptying, but the scores of nausea and early satiety were significantly different between the patients with normal and abnormal intragastric food distribution （nausea： 38.6 ± 3.1 vs 57.1 ± 4.5, P 〈 0.05; early satiety： 40.1 ± 2.4 vs 54.5 ± 3.3, P 〈 0.05）. CONCLUSION： Delayed gastric emptying and/ or abnormal intragastric distribution exist in some patients with FD, and abnormal intragastric food distribution, but not delayed gastric emptying is associated with some upper gastrointestinal symptoms.