液体负荷试验同步胃内压测定评价胃部感觉和容受功能

Evaluation of gastric sensitivity and accommodation by simultaneous determination of intra-gastric pressure in liquid load test

目的评价液体负荷试验（LLT）同步胃内压测定在健康者（HS）和功能性消化不良（VO）患者中的意义。方法40例HS和67例FD患者纳入本研究。调查受试者的人口学特征、FD症状特点和心理状态，然后行LIT同步胃内压测定。结果不同性别、年龄和体质指数HS组胃内压差异均无统计学意义（P〉0．05）。FD组：32．8％存在胃感觉高敏，25．4％存在胃容受功能障碍。不同性别、年龄和症状分型组胃内压和最大饮入量差异均无统计学意义（P〉0．05）。心理评定正常和异常组胃内压[（4．8±1．1）1／11／1Hg比（4．2±1．2）mmHg，P=0．042]和最大饮入量[（526±121）ml比（450±138）ml，P=0．034]差异均有统计学意义。上腹痛、上腹烧灼感、餐后饱胀感和早饱症状与胃内压无相关性（F=1．635，P=0．190）。早饱症状与最大饮人量存在相关性（F=4．682，P=0．031；偏相关系数为一6．8，P=0．033）。受试者耐受性良好。结论LLT同步胃内压测定能够较好地区分胃感觉高敏和容受性障碍，具有良好的可行性、安全性和可靠性。

Objective To extensively evaluate the method of simultaneous determination of intragastric pressure （IGP） in liquid load test （LLT） in healthy subjects （HS） and patients with functional dyspepsia （FD）. Methods Forty HS and 67 FD patients （Rome Ⅲ criteria） were recruited. All subjects were surveyed with regards to demographic characteristics, features of FD symptom spectrum and psychological status （Zung anxiety and depression scale）. And the test of simultaneous determination of IGP in LLT was conducted. Finally all the data were collected and analyzed. Results HS group： no statistical difference was found in IGP divided by gender, age and body mass index （ P 〉 0. 05 ）. The coefficient of variation of IGP at 15.3% was less than that of maximal intake volume （MIV）. Twice repeated studies showed quite similar results and the linear interelass correlation coefficient of IGP was 0. 806 （P = 0. 002 ）. As to the range of normal value from HS, the proportion of gastric hypersensitivity accounted for 35. 0% and impaired accommodation for 25. 0%. FD group ： no statistical difference was found in IGP and MIV divided by gender, age and FD symptom subtype （P 〉 0. 05）. FD patients with abnormal psychological status had a lower IGP （4. 2 ± 1.2 mm Hg vs 4. 8 ±1.1 mm Hg, P =0. 042） and MIV （450 ±138 ml vs 526 ±121 ml, P = 0. 034 ） than those with normal status. IGP was not related to epigastric pain, epigastric burning, postprandial fullness or early satiation （F = 1. 635, P = 0. 190）. Early satiation was significantly related to MIV （F =4. 682, P =0. 031 ; correlation coefficient was -6. 8, P =0. 033）. No statistical difference was found in gastric compliance among HS, all FD patients, patients with hypersensitivity or impaired accommodation （P 〉 0. 05 ）. The test had an excellent safety and tolerability. Conclusions The method of simultaneous determination of IGP in LLT can differentiate gastric hypersensitivity from impaired accommodation. And it has an excellent feasibility, safety and reliability.