胃肠超声造影评估功能性消化不良患者胃排空的临床价值

Clinical value of gastrointestinal contrast-enhanced ultrasonography in evaluating gastric emptying in patients with functional dyspepsia

目的应用胃肠超声造影计算胃排空率,探讨其在评估不同临床类型及不同严重程度功能性消化不良(FD)患者治疗前后胃排空中的临床价值。方法选择在我院就诊的FD患者128例(FD组),其中上腹痛综合征患者68例(EPS亚组),餐后不适综合征患者60例(PDS亚组);另选同期健康成人65例为对照组。应用胃肠超声造影测量FD组和对照组禁食时,试餐后即刻、30 min、60 min、90 min、120 min时全胃腔容积(TGCV)并计算胃排空率,比较两组TGCV及胃排空率随时间变化趋势;临床常规服药治疗FD结束后再次计算120 min胃排空率,比较两亚组及不同严重程度FD患者治疗前后120 min胃排空率。结果 FD组和对照组TGCV随餐后时间变化均呈下降趋势(均P<0.05),且对照组TGCV变化幅度明显大于FD组(P<0.05);FD组餐后30 min、60 min、90 min及120 min时胃排空率均较对照组对应时间点低(均P<0.05),两组胃排空率均随餐后时间的增长而呈上升趋势(均P<0.05)。治疗前,EPS亚组120 min胃排空率显著大于PDS亚组(P<0.05),轻度患者显著大于中度及重度患者,且两两比较差异均有统计学意义(均P<0.05);治疗后,PDS亚组120 min胃排空率显著大于EPS亚组(P<0.05),不同严重程度FD患者比较差异无统计学意义;PDS亚组和EPS亚组,以及各严重程度FD患者治疗后120 min胃排空率均较治疗前提高,差异均有统计学意义(均P<0.05)。结论胃肠超声造影可用于准确、客观地评估FD。应用胃肠超声造影检测发现PDS患者的治疗疗效优于EPS患者,不同严重程度的FD患者均能够得到有效治疗。

ObjectiveTo evaluate the clinical value of gastrointestinal contrast-enhanced ultrasonography(CEUS)in evaluating gastric emptying in patients with functional dyspepsia(FD)of different clinical types and severity before and aftertreatment.MethodsTotally 128 patients with FD who were admitted to our hospital were involved as FD group and furtherdivided into epigastric pain syndrome(EPS)subgroup(n=68)and postprandial discomfort syndrome(PDS)subgroup(n=60).Inthe same period,65 healthy adults were involved as the control group.The total gastric cavity volume(TGCV)and gastric emptyingrate of all subjects were measured when fasting,0 min(immediately after the end of the trial meal),30 min,60 min,90 min,120 min after trial meal,and the change trend of TGCV and gastric emptying rate with time increased in the two groups werecompared.After conventional clinical treatment with FD,the 120-min gastric emptying rate after the meal were calculated againto compare the gastric emptying rates of the two subgroups and the patients with different severity of FD before and after thetreatment.ResultsThe postprandial TGCV of both FD group and control group showed a decreasing trend,but the change ofTGCV in the control group was significantly greater than that in FD group(P<0.05).The gastric emptying rate in both groupswere increased with time increased(P<0.05),but the gastric emptying rate in the FD group at each time point were lower thanthose in the control group(all P<0.05).The 120-min gastric emptying rate of patients in the EPS subgroup before treatment was significantly higher than that in the PDS subgroup(P<0.05),and that in the mild patients was significantly higher than that in themoderate and severe patients,there were statistically significant between each other(all P<0.05).After treatment,the 120-mingastric emptying rate in the PDS subgroup was significantly higher than that in the EPS subgroup(P<0.05),there was nosignificant difference in FD patients with different severity degree.The 120-min gastric emptying rate after treatment in PDSsubgroup and EPS subgroup,as well as in FD patients with each severity degree,were higher than that before treatment,and thedifferences were statistically significant(all P<0.05).ConclusionGastrointestinal CEUS can be used to evaluate FD accuratelyand objectively.Gastrointestinal CEUS shows that PDS patients has better therapeutic effect than EPS patients,and FD patientswith different severity could be effectively treated.