功能性消化不良患者胃排空功能与幽门螺杆菌感染的相关性研究

The relationship between helicobacter pylori infection and gastric empty-ing in patients with functional dyspepsia

目的观察功能性消化不良(FD)患者的胃排空功能,并进一步探讨FD患者幽门螺旋杆菌(HP)感染与胃排空功能的相关性。方法选择FD患者89例,症状均符合罗马Ⅲ标准。入选病例行胃镜检查,根据快速尿素酶检测法及病理活组织检查将患者分为HP阳性组49例和HP阴性组40例,同时选取无症状健康对照组30例。利用实时超声胃窦单切面法,分别测量空腹、500 m L饮水后即刻和饮水后20 min时胃窦近端单切面截面积,并计算20 min时胃排空率、拟胃排空时间、胃排空系数,评估两组FD患者的胃排空功能。结果 1与健康对照组相比,FD患者的20 min时胃排空率、拟胃排空时间、胃排空系数均有改变,差异显著(P<0.05);2FD患者的HP感染率为55.1%,HP阳性组和HP阴性组相比,20 min时胃排空率、拟胃排空时间、胃排空系数略有改变,但无显著性差异(P>0.05)。结论 FD患者的胃排空功能较无症状健康人群明显降低;FD患者是否合并HP感染,对胃排空功能无显著影响,推测FD的胃排空功能异常机制可能是多因素作用的结果。

Objective To study and evaluate the relationship between helicobacter pylori（H. pylori）infection and gastric emptying in patients with functional dyspepsia（FD）, and to discusse whether H. pylori infection is involved in the pathogenetic factors of gastric emptying in FD. Methods A total of 89 patients and 30 healthy controls were enrolled in the study. All patients who had been made a FD diagnosis by the Rome Ⅲ criteria under went gastric mucosa biopsy while doing gastroscopy and were analyzed H. pylori by rapid urase test as well as by histological examination and then were separated into the H. pylori-positive group（49 cases） and the H.pylori-negative group（40 cases） according to the result. The antral cross-sectional area was measured ultrasonographically fasting and after 500 m L water of a liquid meal immediately and 20 minutes later. Statistical adjustment for gastric emptying fraction and the gastric anticipant emptying time as well as gastric emptying rate at 20 minutes was made between two groups. Results 1 Gastric emptying was significantly changed in dyspeptic patients compared with healthy controls（P〈0.05）. 2 H.pylori infection was found in 58.3% of dyspeptic patients. Each index of gastric emptying in H. pylori-positive group compared with H. pylori-negative group had little change, whereas contrast difference had no statistical significance（P〉0.05）. Conclusion It is presumed that the mechanism of gastric emptying in FD possibly ambiguous related to the H. pylori infection.Probable pathophysiologic mechanisms of gastric emptying dysfunction discussied in FD is a consequence of multiple factor.