功能性消化不良患者胃固体排空功能与其临床症状关系的研究

Investigating the relationship of gastric empting of solid and its clinical symptoms in patients with functional dyspepsia.

目的 研究功能性消化不良运动障碍亚型患者胃固体排空功能与其临床症状的关系。方法 对有4周以上腹胀、恶心、食欲减退等症状的患者进行症状评分 ,症状总积分≥ 9分 ,早饱、上腹胀至少具备一项且≥2分者 ,行胃镜、B超等有关检查 ,排除器质性病变后诊断为功能性消化不良运动障碍亚型。确诊患者服用标准试餐加固体小钡条 ,餐后 5h透视确定胃内钡条排空情况 ;同时所观察患者服用西沙必利每次 5mg、每日 3次治疗 ,并于治疗 2周及 4周末复查。结果 功能性消化不良运动障碍亚型中 6 7 5 %的患者有胃排空异常 ,女性与男性无显著性差异 (P >0 0 5 )。治疗前胃排空正常者的症状积分为 10 0 0± 1 41,,胃排空异常者为 11 70±2 2 8,二者相比无明显差异 (P >0 0 5 ) ;治疗 2周及 4周后 ,胃排空正常者的症状积分分别为 4 90± 2 45、2 10± 1 19,胃排空异常者则分别为 7 0 0± 3 12、4 2 0± 2 39,与治疗前相比二者的症状总积分均明显降低 ,而且前者比后者的症状积分更低 (P <0 0 5 )。治疗前患者的症状积分虽与胃内钡潴留无明显相关 (r =0 0 78,P >0 0 5 ) ,但治疗后二者却有一定的相关性 (r =0 47,P <0 0 5 )。结论 功能性消化不良患者有明显的胃排空延迟 ;胃排空延迟确与运动障碍样症状有关 ,但?

Objectives To investigate the relationship between gastric emptying abnormalities and clinical features in patients with functional dyspepsia(FD).Methods In 40 patients with FD,the gastric emptying of solids was measured by a radioscopic technique and nine dyspeptic symptoms were measured as absent,mild,relevant,and severe,according to their influence on patients' usual activities.All patients were treated with Cisapride for four weeks and repeated examination were performed in 2nd,4th weekend respectively.Results Delayed gastric emptying was detected in 67 5% of dyspeptics and no difference between men and women(P>0 05).Before treatment,patients with delayed gastric emptying(GE) had no significant increase in symptom severity,with a mean total symptom score of 11 7 compared with patients with normal GE,who had a mean total symptom score of 10(P>0 05),but the difference was significant after administration of Cisapride two weeks and four weeks later(7 00±3 12,4 20±2 39 vs 4 90±2 45,2 10±1 19,P<0 05) respectively.Correlation of total symptom score with percentage retention at 5 hours on GE radioscopy was not significant(r=0 078,P>0 05),but the difference was statistically significant with Cisapride administrated(r=0 47,P<0 05).Conclusions The dysmotility-like symptoms in patients with FD may be attributed to gastric emptying.Symptoms in all patients and delayed gastric emptying in partial can be improved at some extent after administration of Cisapride.