不同亚型功能性消化不良胃肌电活动的研究

Gastric myoelectrical activity in subgroup of patients with functional dyspepsia

目的 研究功能性消化不良(FD)的胃肌电活动并探讨其在不同亚型功能性消化不良中的的差异。方法 健康对照组15例,FD64例,按罗马Ⅱ分型标准,溃疡样FD30例,运动障碍样FD34例。应用体表胃电图(EGG)记录胃肌电活动,餐前和标准餐后各30分钟,应用频谱分析法分析并比较正常受试者与FD及其不同亚型的EGG参数。以餐前或餐后正常胃慢波百分比<70％为异常EGG。结果 溃疡样FD和运动障碍样FD异常EGG分别为73.33％和67.64％,显著高于正常组的6.67％(P<0.005)。溃疡样FD和运动障碍样FD功率比<1者分别为46.67％和47.06％,显著大于正常组(0％,P<0.005)。二型FD正常胃慢波明显小于正常组,但胃动过缓显著大于正常组(P<0.05)。除餐前DPIC运动障碍样FD(78.91%)明显大于溃疡样FD外(46.27%,P<0.05),其余各EGG参数二型FD之间比较均无差异(P>0.05)。结论大多数FD病人的EGG异常;EGG可作为FD的筛选检查;溃疡样FD和运动障碍样FD胃电活动无明显差异。

Objective To investigate gastric myo-electrical activity in subgroup of patients with functional dyspepsia. Methods The study was conducted in 15 healthy subjects and 64 patients with functional dyspepsia, of 64 patients, 30 patients were classified as ulcer-like dyspepsia and 34 as dysmotility-like dyspepsia, according to the Rome II classification. Gastric myoelectrical activity was recorded using cutaneouse electrogastrograghy (EGG) for 30 min in the fasting state and 30 min after a standard test. Spectral analysis methods were applied to derived quantitative EGG parameters. The abnormal EGG was defined as <70% of the normal 2-4cpm slow wave. Results Both patients with ulcer-like dyspepsia and with dysmotili-ty-like dyspepsia had a significantly higher abnormal EGG (73.33% and 67.64%, respectively) and had higher power ratio <1(46.67% and 47.06% respectively) than did healthy controls (6.67% and 0% respectively,P<0.005). Two subgroups of pa- tients with functional dyspepsia had a significantly lower mean percentage of 2-4 cpm slow waves and a significantly higher percentage bradygastria, both in the fed state and in the fasting state, than did healthy subjects (P<0.05). In comparison with the patients with ulcer-like dyspepsia,the patients with dysmotility-like dyspepsia had a significantly higher instability of the dominant power (DPIC) only in the fasting state (46.27% vs 78.91%, P<0.05), and there were not significant difference between the two subgroups of patients in other EGG parameters. Conclusions The EGG is abnormal in most of functional dyspepsia patients. EGG could serve as an initial simple screening tool .There are no significant difference between patients with ulcer-like dyspepsia and with dysmotility -like dyspepsia in gastric, myoelectrical activity.