自主神经功能在肥胖者机械性胃扩张模拟进餐过程中的变化特征  

Characteristics of autonomic nervous activity in obese people during mechanical gastric distension that mimics gastric filling

作　　者：张学丛 姚树坤[2] 常丽丽[1] 郝顺霞[3] 赵英丽[1] 高富贵[3] 

机构地区：[1]石家庄市第一医院消化内科,河北省石家庄市050011 [2]卫生部中日友好医院,北京市100029 [3]河北省卫生厅卫生监督局,河北省石家庄市050071

出　　处：《世界华人消化杂志》2009年第25期2621-2624,共4页World Chinese Journal of Digestology

基　　金：石家庄市科技局2008年石家庄市科学技术研究与发展基金资助项目;No.08146483~~

摘　　要：目的:观察单纯性肥胖者机械性胃扩张模拟进餐过程中自主神经的变化特征,探讨其与肥胖者胃内脏感觉异常的关系.方法:采用电子恒压器和动态心电记录仪,对67例单纯性肥胖者与32例正常体质量健康志愿者进行胃底机械性扩张,模拟进餐过程,记录其进餐过程中的心电信号,通过心率变异分析,观察自主神经功能的变化.结果:机械性胃扩张前静息状态肥胖组TP、ULF、LF、HF显著高于对照组(P<0.01或P<0.05).初始饱感状态静息状态TP、ULF、LF、HF差值差异显著(P<0.01),肥胖组显著高于对照组(均P<0.01).最大耐受饱感状态与静息状态TP、ULF、LF、HF差值差异显著,肥胖组显著高于对照组(均P<0.01).结论:肥胖者较正常体质量者胃容积增加,顺应性增高,容受性增强及饱感延迟发生与自主神经功能异常有密切关系.AIM： To investigate the characteristics of autonomic nervous activity in obese people during mechanical gastric distension and analyze the relationship between autonomic nervous function and gastric sensitivity.METHODS： Sixty-seven obese subjects and thirty-two normal controls were studied using a barostat and an electrocardiograph. Before and during mechanical distension of the proximal stomach, myocardial electrical activity was recorded, and heart rate variability （HRV） analysis was performed.RESULTS： At baseline, obese subjects had significantly higher total power （TP）, ultra-low-frequency power （ULF）, low-frequency power （LF） and high-frequency power （HF） in the HRV power spectrum than control ones （all P 〈 0.01 or 0.05）. At initial satiety level, TP, ULF, LF and HF values declined compared with baseline values, and the changes in these values were significantly greater in obese subjects than in control ones （all P 〈 0.01）. At maximal tolerated volume, TP and ULF values increased while LF and HF values decreased, and the changes in these values were significantly greater in obese subjects than in control ones （both P 〈 0.01）.CONCLUSION： Obese people have large gastric capacity, higher gastric compliance and accommodation, and delayed satiety compared to nonobese ones, which is closely associated with abnormal autonomic nervous function.

关 键 词：单纯性肥胖 机械性胃扩张 自主神经 电记录仪 

分 类 号：R589.2[医药卫生—内分泌] R573[医药卫生—内科学]