标准餐、平板运动试验对健康人体表胃肠电图的影响  

Effects of standard meal and treadmill exercise test on cutaneous gastrointestinal electrogram in healthy subjects

作　　者：王琳[1,2] 潘飞 石亚君[3] 郜玲[3] 王晋丽[3] 沈蕾[1] 张晓梅[1] 陈韵岱[3] 彭丽华[1] Wang Lin;Pan Fei;Shi Yajun;Gao Ling;Wang Jinli;Shen Lei;Zhang Xiaomei;Chen Yundai;Peng Lihua(Department of Gastroenterology and Hepatology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Chinese PLA Medical School,Beijing 100853,China;Department of Vasculocardiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心消化内科医学部,北京100853 [2]解放军医学院,北京100853 [3]解放军总医院第一医学中心心血管内科,北京100853

出　　处：《中华消化杂志》2023年第8期537-544,共8页Chinese Journal of Digestion

基　　金：联勤保障部队战勤部特殊装备科研(LB2020lA060003)。

摘　　要：目的探究标准餐、平板运动试验对健康人体表胃肠电图的影响,为胃肠电图的临床应用提供更多依据。方法于2021年1月至6月招募100名无症状健康志愿者分别在空腹、标准餐和平板运动后进行体表胃肠电描记。受试者空腹8 h以上,在胃体、胃小弯、胃大弯、胃窦、升结肠、横结肠、降结肠、直肠体表投影位置放置电极。受试者平卧待安静、呼吸平稳后进行胃肠电采集,记录6 min空腹胃肠电图;进食标准餐(面包100 g,牛奶250 mL)后平卧5~10 min,记录6 min餐后胃肠电图;平板运动试验后平卧5~10 min,记录6 min平板运动后胃肠电图。比较3个时间点的胃肠电波形平均频率和幅值,以及胃肠电节律紊乱百分比、慢波频率不稳定系数等。根据年龄、性别、体重指数进行胃动力分层分析。统计学方法采用配对t检验、Pearson卡方检验、连续性校正卡方检验、Fisher确切概率法和Spearman相关性分析。结果标准餐后胃电的波形平均频率与空腹时比较无改变;波形平均幅值较空腹时显著增高,在胃小弯[(148.5±8.7)μV比(113.2±5.0)μV]、胃大弯[(176.3±11.3)μV比(126.1±7.3)μV]和胃窦[(161.8±10.6)μV比(117.6±4.9)μV]差异均有统计学意义(t=4.63、4.63、3.99,均P<0.001);胃电节律和稳定性无明显改变。标准餐后肠电波形平均频率较空腹时下降,在升结肠[(10.8±0.2)次/min比(11.5±0.2)次/min]、横结肠[(10.5±0.2)次/min比(11.2±1.6)次/min]、降结肠[(10.9±0.2)次/min比(11.7±0.2)次/min]、直肠[(11.1±0.2)次/min比(11.8±0.2)次/min]差异均有统计学意义(t=3.82、4.55、4.39、3.98,均P<0.001);肠电波形平均幅值较空腹时增高,在升结肠[(129.8±6.1)μV比(110.9±6.4)μV]、横结肠[(119.6±4.1)μV比(101.3±4.7)μV]、直肠[(124.1±4.6)μV比(106.2±5.7)μV]差异均有统计学意义(t=2.62、3.76、3.16,P=0.010、<0.001、=0.002);肠电节律紊乱导联总数增多[398条比389条(总导联数均为400条)],差异�Objective To explore the effects of standard meal and treadmill exercise test on body surface gastrointestinal electrogram in healthy subjects,and to provide more evidence for the clinical application of gastrointestinal electrogram.Methods From January to June 2021,a total of 100 healthy asymptomatic volunteers underwent gastrointestinal electrogram after fasting,standard meal and treadmill exercise test.After the subjects fasted for more than 8 hours,the gastrointestinal electrogram was performed after the subjects were lying flat,quiet,and breathing steadily,electrodes were placed on the the body surface projection positions of the gastric body,the lesser curvature,the greater curvature,the antrum,the ascending colon,the transverse colon,the descending colon,and the rectum.The fasting gastrointestinal electrogram was recorded for 6 min.Then lay for 5 to 10 min after the standard meal(100 g bread,250 mL milk),the postprandial gastrointestinal electrogram was recorded for 6 min.And lay for 5 to 10 min after treadmill exercise test,then the postexercise gastrointestinal electrogram was recorded for 6 min.The frequency and amplitude of gastrointestinal electrogram waveforms of the three time points were compared,and the percentage of gastrointestinal electrical rhythm disorder,and slow wave frequency instability coefficient were also compared.Stratified analysis of gastric motility was performed according to age,sex and body mass index.Paired t-test,Pearson Chi-squared test,continuity correction Chi-squared test,Fisher′s exact method and Speraman correlation were used for statistical analysis.Results The standard meal did not obviously affect the mean frequency of the gastric electrocardiogram,however the mean amplitude of gastric electrocardiogram significantly increased after standard meal compared with that of fasting,especially in the electrodes placed at lesser curvature((148.5±8.7)μV vs.(113.2±5.0)μV),greater curvature((176.3±11.3)μV vs.(126.1±7.3)μV),and antrum((161.8±10.6)μV vs.(117.6±4.91)μV

关 键 词：运动试验 标准餐 体表胃肠电图 健康志愿者 胃动力 

分 类 号：R57[医药卫生—消化系统]