功能性消化不良患者小肠动力学检测及临床意义研究

Disorder of small intestinal motility in functional dyspepsia

目的探讨功能性消化不良(functional dyspepsia,FD)患者口盲肠传输时间(oro-cecal transit time,OCTT)和小肠细菌过度生长(small intestinal bacterialovergrowth,SIBO)及与胃排空延迟的关系。方法 41例FD患者与13例健康者行乳果糖氢呼气试验和小钡条法胃排空试验,通过观察呼气氢浓度基础值、产氢高峰的变化曲线测定OCTT及了解有无SIBO;观察胃内钡条排空率确定有无胃排空延迟。结果(1)FD组29例患者行胃排空检查,胃排空延缓占58.6%。对照组胃排空占20.0%;两组比较差异有统计学意义(P<0.05);(2)41.5%(17/41)FD患者OCTT结果异常,且其中有29.4%(5/17)的患者合并有SIBO,而对照组无异常;87.8%(36/41)无SIBO的FD患者OCTT为(110.8±45.0)min,较对照组的(78.3±19.0)min明显延长,差异有统计学意义(P<0.05);(3)FD患者OCTT延长与胃排空延迟及SIBO均无相关性。结论 FD患者OCTT时间较对照组明显延长,但与胃排空延迟与SIBO均无相关性,提示小肠动力异常可能是FD的发病的独立原因之一。

Objective To investigate the relationship between oro- cecal transit time （OCTT） and smal intestinal bacterial overgrowth （SIBO） in functional dyspepsia （FD） patients. Methods 41 patients with FD and 13 healthy subjects were enrol ed in the study. The OCTT was determined by hydrogen breath test,gastric emptying test was performed with smal barium strip method. The baseline value of hydrogen and change curve of hydrogen peak were used to analyze whether the SIBO was present;and gastric emptying rate was used to judge the existence of delayed gastric emptying. Results 29 FD patients underwent gastric emptying test,the rate of delayed gastric emptying in FD patients was higher than that in controls （58.6%vs.20.0%, P〈0.05）. Abnormal OCTT was detected in 17 FD patients（41.5%）,among whom 5 were complicated with SIBO （29.4%）;while there was no abnormality OCTT detected in control group. OCTT in 36 FD patients without SIBO was significant longer than that in controls （110.8±45.0min vs. 78.3±19.0 min, P〈0.05）. The extension of OCTT in FD patients had no correlation with delayed gastric emptying and SIBO. Conclusion The results suggest that intestinal motility disorders may be one of the independent causative factors for development of functional dyspepsia.