功能性消化不良患者幽门与胃窦十二指肠运动的时空关系  

Temporal and spatial relationship of pylorus to antroduodenal motility in functional dyspepsia

作　　者：谷成明[1] 柯美云[1] 王智凤[1] 孙颖[1] 

机构地区：[1]中国协和医科大学中国医学科学院北京协和医院,北京市100730

出　　处：《中华消化杂志》1997年第S1期38-41,共4页Chinese Journal of Digestion

摘　　要：目的：了解功能性消化不良患者幽门与胃窦十二指肠运动的时空关系。方法：通过连续5小时上消化道测压，观察11例健康人（HS）和14例功能性消化不良（FD）患者消化间期和消化期胃窦幽门十二指肠运动功能变化。结果：HS组胃窦部、幽门、十二指肠移行性复合运动（MMC）Ⅲ期出现率为7／11、8／11和10／11，FD组分别为3／14（P＜0．05）、4／14（P＜0．05）和6／14（P＜0．05）。消化间期MMCⅡ期胃窦幽门十二指肠协调收缩占58．5％，显著高于FD组（18．5％，P＜0．001）。HS和FD组消化期幽门十二指肠的协调收缩在60分钟时分别为78．2％、38．9％（P＜0．01），120分钟时为77．1％和54．0％（P＜0．01）；幽门孤立性收缩波在餐后60分钟分别为4．8％、29．7％（P＜0．001），120分钟为9．3％、25．1％（P＜0．01）。结论：幽门与胃窦十二指肠动力活动的时空关系，在胃排空中具有重要的作用。FD患者的胃窦幽门十二指肠在消化间期和消化期均有异常。可能涉及神经调节异常．Objective: To investigate the temporal and spatial relationship of pylorus to antroduodenal motility in functional dyspepsia (FD). Methods: We studied 11 healthy subjects (HS) and 14 patients with FD. An 8-channel Dent-sleeve catheter was positioned under fluoroscopic guidance across antro-pyloro-duodenal region. antral-pyloro-duodenal manomatry was performed for 3 hours during fasting and 2 hours after a 80kcal of solid test meal. Results: (1) The frequency of phase Ⅲ was 7/11 in HS and 3/14 in FD in antrum (P<0.05), 8/11 and 4/14 in pylorus (P<0.05),10/11 and 6/14 in duodenum (P<0.05), respectively. (2) The percentage of antro pyloro-duodenal coordinativg contractions during phase Ⅱ of MMC was 58.5% in HS and 18.5% in FD (P<0.001).(3) The pyloroduodenal coordinatively contraction was 78.2% and 38.9%(P<0.01) at 60min after meal and 77.1% and 54.0% (P<0.01) at 120min postprandually in HS and in FD, respectively. (4)The percentage of isolated pyloric pressure waves (IPPW) was 4.8%, 29.7 % (P<0.001) at 60min, and 9.3%. 25.1%(P<0.01) at 120min in HS and FD. Conclusions: There were abnormalities of gastro-pyloro-duodenal motility in both interdigestive and digestive periods; the higher frequency of IPPWs and disordered temporal and spatial relationship of pylorus to antroduodenal motility may result in delayed gastric emptying in FD. The possible mechanism may be due to abnormal neural control.

关 键 词：胃窦幽门十二指肠运动 移行性复合运动 功能性消化不良 

分 类 号：R573.9[医药卫生—消化系统]