符合罗马Ⅲ标准的功能性消化不良患者固体胃排空功能研究  

Solid Gastric Emptying Function in Patients with Functional Dyspepsia Fulfilling Rome Ⅲ Criteria

作　　者：宋志强[1,2] 柯美云[1] 王智凤[1] 陈黎波[3] 王正华[3] 方秀才[1] 刘晓红[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院消化内科,100730 [2]北京大学第三医院消化内科,100083 [3]中国医学科学院中国协和医科大学北京协和医院核医学科,100730

出　　处：《胃肠病学》2008年第9期528-531,共4页Chinese Journal of Gastroenterology

摘　　要：背景:罗马Ⅲ标准对功能性消化不良(FD)的定义作了更新和修订,相应FD患者人群亦发生改变。目的:研究符合罗马Ⅲ标准的FD患者的固体胃排空功能,以及新的FD症状谱和分型与固体胃排空功能之间的关系。方法:对36例符合罗马Ⅲ标准的FD患者和32名健康志愿者行99Tc固体胃排空试验。比较不同症状分型FD患者的固体胃排空功能,分析固体胃排空功能与罗马Ⅲ标准中FD症状的相关性。结果:10例(27.8%)FD患者固体胃半排空时间超过正常上限,9例(25.0%)2h残留率高于正常上限。餐后不适综合征(PDS)、上腹痛综合征(EPS)和PDS+EPS型FD患者固体胃半排空时间分别为(150.3±40.2)min、(118.3±25.1)min和(150.5±51.2)min,三组间差异无统计学意义(P=0.126)。餐后饱胀不适症状与固体胃半排空时间和2h残留率均呈线性正相关,相关系数分别为11.5(P=0.043)和0.045(P=0.040)。结论:本组27.8%的FD患者存在固体胃排空延迟。PDS和PDS+EPS型FD的固体胃半排空时间有长于EPS的趋势。FD患者的餐后饱胀不适症状与固体胃排空延迟有关,固体胃排空延迟是符合罗马Ⅲ标准的FD患者的病理生理机制之一。Background： In Rome Ⅲ criteria, the definition of functional dyspepsia （FD） was updated and revised, which had resulted in the alteration of FD population. Aims： To investigate the solid gastric emptying function in FD patients fulfilling Rome Ⅲ criteria and the correlation of solid gastric emptying function with symptoms and diagnostic categories of FD. Methods： Thirty-six FD patients fulfilling Rome Ⅲ criteria and 32 healthy volunteers were enrolled in this study. The solid gastric emptying function was determined by ^99Tc-labeled scintigraphic method and was mutually compared among FD patients with different diagnostic categories. The correlations of solid gastric emptying function with FD symptoms in Rome Ⅲ criteria were analyzed. Results： Ten （27.8%） FD patients had a longer solid gastric half emptying time than upper limits of normal, while 9 （25.0%） had a higher residue rate of 2 hours than upper limits of normal. The solid gastric half emptying time of patients with postprandial distress syndrome （PDS）, epigastric pain syndrome （EPS）, and PDS＋EPS were （150.3±40.2） min, （118.3±25.1） min, and （150.5±51.2） min, respectively, no significant difference was found between these three groups （P=0.126）. Bothersome postprandial fullness was positively correlated with both solid gastric half emptying time and residue rate of 2 hours, the correlation coefficients were 11.5 （P=0.043） and 0.045 （P= 0.040）, respectively. Conclusions： Delayed solid gastric emptying was present in 27.8% of FD patients enrolled in this study. Patients with PDS and PDS＋EPS appear to have a longer solid gastric half emptying time than EPS. Bothersome postprandial fullness is correlated with delayed solid gastric emptying in FD patients. Delayed solid gastric emptying is one of the pathophysiologic mechanisms in FD patients fulfilling Rome III criteria.

关 键 词：罗马Ⅲ标准 消化不良 功能性 胃排空 体层摄影术 发射型计算机 单光子 诊断 

分 类 号：R57[医药卫生—消化系统] R-09[医药卫生—内科学]