消化不良患者的胃幽门十二指肠运动协调性研究

Gastro-pyloro-duodenal Motor Cooperation in Patients with Dyspepsia

目的 探讨胃幽门十二指肠运动在消化不良患者的胃固体、液体排空中的作用。方法 采用核素法、复合超声及测压法研究健康人 (HS)、功能性消化不良 (FD)患者及糖尿病性消化不良 (DD)患者的胃幽门十二指肠的动力。结果 FD组、DD组与 HS组相比 ,其胃中间横带 (MTB)显著增宽 (P<0 .0 1和 P<0 .0 0 1) ,而胃固体半排空延缓 ;液体排空周期和最大排空速率降低 ,且胃窦幽门十二指肠的协调收缩显著下降 ;前两组的移行性复合运动 期发生率低于 HS组 , 期的胃幽门十二指肠协调收缩降低。结论 MTB明显影响胃内食物分布。FD、DD患者的胃窦幽门十二指肠运动不协调是胃固体、液体排空延缓的重要因素 ,但 FD和 DD的发病机制不同。

To investigate the role of the midgastric transverse band(MTB)and gastro-pyloro-duodenal motility in functional dyspepsia(FD) and diabetic dyspepsia(DD). Methods Healthy subjects,patients with FD and DD participated in the study.Of them,65 subjects received radionuclide gastric emptying,48 complex ultrasonograph,and 35 gastro-pyloro-duodenal manometry. Results (1) MTB was (7.01±1.31),(3.39±0.21)cm in FD and DD,which was significantly wider than that in HS group [(2.42±0.16)cm,P<0.01,P<0.001].(2) The half gastric emptying time (t 1/2)in FD and DD were prolonged,gastric remained rate at 120 min increased,the gastric emptying velocity reduced when compared with HS.(3) The gastric occlusive and non-occlusive peristaltic contractions could be clearly shown under ultrasonograph.The percentage of emptying circle >10 seconds was reduced in FD and DD.(4) There was decreased number of migrating motor complex phase Ⅲ in FD and DD,when compared with HS. Conclusions MTB is an area with physiological function,which affects intra-gastric food distribution.Patients with FD and DD showed delayed gastric emptying associated with decreased gastric motor activity and antro-pyloro-duodenal in-cooperative function. There may be different pathogenesis in FD and DD.Further study needs to be performed.