健康人和功能性消化不良病人胃移行性复合运动与胃电图的关系及胃动素变化  

Relationship between gastric migrating motor complex and electrogastrography and alteration of plasma motilin in healthy subjects and patients with functional dyspepsia

作　　者：杨春敏[1] 徐文洁[2] 周吕[1] 郝维[1] 曹传平[3] 迟宝吉 

机构地区：[1]中国医学科学院中国协和医科大学基础医学研究所生理系,100005 [2]中国科学院合肥分院 [3]北京空军总医院

出　　处：《中华消化杂志》1997年第S1期42-46,共5页Chinese Journal of Digestion

基　　金：国家自然科学基金!39570278

摘　　要：目的：为了观察健康人体表胃电图（EGG）能否反映消化间期胃移行性复合运动（MMC），功能性消化不良（FD）病人消化间期MMC和EGG是否异常，以及健康人和FD病人在MMC启动中血浆胃动素的变化．方法：对12名健康人和20例FD病人同时进行3小时胃内压力和EGG测定。结果：（1）健康人胃MMC呈现时相变化，EGG参数变化与MMC时相密切相关。在MMCⅢ相时EGG的振幅（AP）值明显高于Ⅰ相和Ⅱ相（P＜0．01）。EGG的主功率和主频率较Ⅰ相时稳定。（2）FD病人消化间期存在明显胃窦动力低下，大部分病人胃MMCⅢ相缺失。EGG的Ap值在MMC各时相无差别，但EGG的Ap值在MMCⅡ相、Ⅲ相时明显低于健康人的Ⅱ相、Ⅲ相（P＜0．05）。同时，FD病人表现明显的胃节律紊乱．（3）健康人血浆胃动素浓度在MMCⅢ相时最高．FD病人MMC各时相血浆胃动素浓度均低于健康人（P＜0.01）。结论：（1）EGG可以反映MMC的不同时相。（2）EGG能反映FD病人胃动力状态。（3）血浆胃动素是触发胃MMCⅢ相的因素．而FD病人胃动力低下和胃节律紊乱与低胃动素水平有关。Objective: In order to investigate whether different phases (phase Ⅰ, Ⅱ and Ⅲ) of interdigestive migrating motor complex (MMC) can be recognized via cutaneous electrogastrography (EGG); whether gastric motility and EGG abnormalities exist in the patients with functional dyspepsia (FD); and the role of plasma motilin on the initiation of MMC. Methods:Simultaneous measurements of gastric pressure and EGG were performed in fasting state in 12healthy subjects and 20 FD patients for 3 hours, and blood samples were taken in different phases of MMC for evaluation of plasma motilin. Results: (1) In healthy subjects, the amplitude (AP) of EGG was higher during phase Ⅲ than that during phase Ⅰ (P<0.01), and dominant power and dominant frequency were more stable in phase Ⅲ than those in phase Ⅰ. (2) In FD patients, antral hypomotility existed in interdigestive period, and the number of gastric MMCs was significantly less as compared with healthy subjects. Ap levels of EGG had no difference among different phases of MMC in FD patients, but AP levels in phase Ⅱ and Ⅲ were lower than those in healthy subjects (P<0.05). Meanwhile, there was a high frequency of dysrhythmias during fasting FD patients. (3) Plasma motilin levels reached peak level in phase Ⅲ in both groups. Plasma motilin levels in different phases of MMC of FD patients were obviously lower than those healthy subjects (P<0.01).Conclusions: (1) Different phases of MMC may be identified via cutaneous EGG. (2) EGG can reflect gastric motility in FD patients. (3) Plasma motilin is the factor which initiates the gastric MMC. (4) Antral hypomotility and a high frequency of dysrhythmias may be related to decreased plasma motilin level in interdigestive period of FD patients.

关 键 词：移行性复合运动 胃电图 胃动素 功能性消化不良 

分 类 号：R573.9[医药卫生—消化系统]