功能性消化不良消化间期和消化期体表胃电研究

Electrogastograph During Interdigestive and Digestive Stages in Patients with Functional Dyspepsia

目的 观察健康人及功能性消化不良 (FD)患者消化间期和消化期体表胃电 (EGG)的动态变化规律及探讨胃电与胃窦机械收缩间的关系。方法 采用 PC Polygraph HR台式高分辨上消化道动力监测系统对 11例健康人和 14例 FD患者连续 5 h同步记录体表胃电和胃窦幽门、十二指肠的压力变化。结果 健康人胃电功率随消化间期移行性复合运动 (MMC)的周期性变化而变化 , 期时增高 ,约为 期的 2倍 ; 期最高 ,约为 期时的 2 .5倍 ;餐后功率与 期接近 ;FD患者胃电功率只在餐后 30 min升高。两者消化间期胃电功率和胃窦动力指数均呈正相关(正常组 r=0 .87,P<0 .0 1;FD组 r=0 .79,P<0 .0 1)。结论 体表胃电可以反映 MMC周期性变化和胃窦运动功能 ,FD患者餐后胃电功率减低。

To investigate the relationship between dynamic change of electrogastrogram (EGG) with motility index of antrum during migrating motor complex (MMC) cycle in healthy subjects and functional dyspepsia,and to verify whether a 100% coupling of electrical and mechanical events existed after meal. Methods Eleven healthy subjects (HS) and 14 patients with functional dyspepsia (FD) were studied.An 8-channel Dent-sleeve catheter was positioned under fluoroscopic guidance across antropyloroduodenal region and bipolar electrodes were attached to the skin corresponding to the location of antrum.Antropyloroduodenal pressure waves and electrical signals were transferred simutaneously to PC Polygraph(CTD)and recorded for 3 hours preprandially and 2 hours after ingestion of 40 g solid meal(336 kJ).The power of EGG and motility index (MI)of antral contractions were calculated as the area under curve (AUC) by a build-in computer program. Results The power increases of EGG increased significantly in phase Ⅱ(P<0.01),phaseⅢ(P<0.01) and after meal (P<0.01) compared with phase I in HS,however,this dynamic increase was not found in FD.The power of EGG was positively correlated with the motility index of antrum both in HS (r=0.87,P<0.01) and in FD (r=0.79,P<0.01) during the interdigestive period.A significant increase of EGG power after meal was found in HS,which corresponded to the degree of phase Ⅲ and kept stable for the whole postprandial period.In contrast,power increase was not found in FD except during 30 min after test meal. Conclusions Prolonged cutaneous EGG recording can reflect the periodic variation of MMC cycle.EGG response in HS but not in FD after meal is characterized as persistent increase which is corresponded to phaseⅢ.