睡眠障碍对功能性消化不良患者胃运动功能影响  

Effect of sleep disorder on gastric motility in patients with functional dyspepsia

作　　者：张超[1] 王景杰[1] 卢王[1] 杨琦[1] 李慧艳[1] 黄裕新[1] 

机构地区：[1]第四军医大学唐都医院消化内科,西安710038

出　　处：《山西医科大学学报》2010年第10期895-898,共4页Journal of Shanxi Medical University

摘　　要：目的探讨睡眠障碍(sleep disorder,SD)对胃运动功能的影响及相关机制,为临床治疗提供理论依据。方法睡眠障碍按照匹兹堡睡眠质量指数量表诊断,功能性消化不良(functional dyspepsia,FD)按照罗马Ⅲ诊断标准诊断。研究对象来自门诊和住院连续病例,共34例,A组:睡眠障碍伴功能性消化不良患者26例;B组:功能性消化不良患者8例。选择健康志愿者8例作为对照(C组)。用多导睡眠仪和胃电图记录仪对各试验者进行整晚同步监测,在对不同试验组睡眠参数进行对比分析的基础上,重点观察睡眠期的浅睡眠S2期、深睡眠S4期的胃肌电主频、胃动过缓、正常慢波、胃动过速百分比变化情况。次日晨起抽取静脉血,用放射免疫法测定血浆胃动素、生长抑素水平。结果 A组较B、C组总睡眠时间、深睡眠时间、快眼动睡眠时间、睡眠效率明显减少,睡眠潜伏期延长,差异有统计学意义(P<0.05),A组较B组在深睡眠比例、快眼动睡眠减少,差异有统计学意义(P<0.05);总记录时间三组间比较差异无统计学意义。A组S2、S4、快眼动睡眠期胃电主频较B组、C组下降(P<0.05)。②A组血浆胃动素、生长抑素水平均比B组、C组升高(P<0.05),B组血浆胃动素、生长抑素水平比C组降低(P<0.05)。结论睡眠障碍伴功能性消化不良患者睡眠各期胃肌电主频降低,血浆胃动素、生长抑素分泌增加,提示睡眠障碍与功能性消化不良密切相关。睡眠障碍影响胃运动功能的机制可能与血浆胃动素、生长抑素的变化有关。Objective To explore the effect of sleep disorder on gastrointestinal tract motivation in patients with functional dyspepsia and its mechanism.Methods Sleep disorder was diagnosed according to Pittsburgh sleep quality index and polysomnogram,and functional dyspepsia was diagnosed according to Rome Ⅲ criteria.Thirty-four patients were enrolled from out-patient clinic or were hospitalized in our hospital,including 26 patients with sleep disorder and functional dyspepsia（group A）and 8 patients with functional dyspepsia（group B）.Eight healthy volunteers were chosen as controls（group C）.The subjects were monitored synchronically the whole night using polysomnometer and electrogastrogram recorder.Sleep parameters were compared among 3 groups.The changes of percentage of gastric myoelectricity basic frequency,bradygastria,normal slow wave,tachygastria in somnolence S2 period and deep sleep S4 period were observed.The levels of motilin and somatostatin in venous blood was determined with radioimmunity method in the next morning.Results ①Whole sleep time,sleep delitescence,deep sleep ratio,rapid eye move ratio,sleep efficiency in group A decreased compared with group B and group C（P〈0.05）.Deep sleep time and rapid eye move sleep time in group A were shorter than in group B（P〈0.05）.There was no significant difference in whole record time among 3 groups（P〉0.05）.Compared with group B and group C,basic frequency of S2,S4,rapid eye move in group A decreased（P〈0.05）.②Level of motilin and somatostatin in group A were significantly higher than in gorup B and group C（P〈0.05）,while the levels of motilin and somatostain in group B were lower than in group C.Conclusion The results suggest that sleep disorder is closely correlated to functional dyspepsia.The mechanism of sleep disorder affecting the gastric motility is possibly concerned with changes of motilin and somatostatin.

关 键 词：睡眠障碍 功能性消化不良 胃肌电活动 脑肠肽 

分 类 号：R574.4[医药卫生—消化系统]