肥胖症患者胃电节律特征分析  

The characteristics of gastric electric rhythm in obese patients

作　　者：张若曦 陈洋[2] 王智凤[2] 徐强[3] 李涛[4] 费贵军[2] 方秀才[2] 李晓青[2] Zhang Ruoxi;Chen Yang;Wang Zhifeng;Xu Qiang;Li Tao;Fei Guijun;Fang Xiucai;Li Xiaoqing(Department of Internal Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Phychological Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内科,北京100730 [2]中国医学科学院,北京协和医学院,北京协和医院消化内科,北京100730 [3]中国医学科学院,北京协和医学院,北京协和医院基本外科,北京100730 [4]中国医学科学院,北京协和医学院,北京协和医院心理医学科,北京100730

出　　处：《中华医学杂志》2024年第45期4146-4152,共7页National Medical Journal of China

摘　　要：目的探究肥胖症患者的胃电节律特征。方法前瞻性纳入2018年1月至2024年2月北京协和医院拟行减重手术的肥胖症患者,根据体质指数(BMI)分为轻中度肥胖组(28 kg/m^(2)≤BMI<40 kg/m^(2))和重度肥胖组(BMI≥40 kg/m^(2));选择同期就诊的BMI正常范围(18.5 kg/m^(2)≤BMI<25 kg/m^(2)),无上消化道症状、胃肠道手术史、糖尿病等基础疾病,拟行体表胃电图(EGG)检查的人群作为正常BMI组。收集患者一般信息,并进行EGG检查与分析,比较轻中度、重度肥胖症患者及正常BMI组的胃电节律特征,分析BMI与胃电节律参数的相关性,并比较合并糖尿病的肥胖症患者和未合并的肥胖症患者EGG参数的差异。结果共纳入60例肥胖症患者,男25例,女35例,年龄18.0~59.0(27.6±6.9)岁,BMI为(41.0±7.1)kg/m^(2);其中,轻中度肥胖组和重度肥胖组各30例。正常BMI组24例,男11例,女13例,年龄21.0~42.0(30.7±6.8)岁,BMI为(22.7±3.1)kg/m^(2)。轻中度、重度肥胖组与正常BMI组间年龄、性别差异均无统计学意义(均P>0.05)。EGG结果显示,轻中度肥胖组和重度肥胖组餐前正常慢波节律百分比(分别43.2%±20.0%、37.0%±16.9%比74.6%±13.6%)及餐后正常慢波节律百分比(分别31.6%±13.8%、28.5%±11.3%比68.5%±14.4%)均低于正常BMI组(均P<0.001)。轻中度肥胖组的餐前胃动过缓百分比[M(Q1,Q3),3.4%(0,15.2%)比0(0,0),P<0.001]、餐前胃动过速百分比[0(0,3.3%)比0(0,0),P=0.014]及餐后胃动过缓百分比[13.3%(3.3%,20.4%)比0(0,5.2%),P<0.001]均高于正常BMI组;重度肥胖组的餐前胃动过缓百分比[9.4%(3.1%,13.8%)比0(0,0),P<0.001]、餐前胃动过速百分比[0(0,3.7%)比0(0,0),P=0.011]、餐后胃动过缓百分比[16.7%(7.4%,20.0%)比0(0,5.2%),P<0.001]均高于正常BMI组。轻中度肥胖组、重度肥胖组餐前主功率[分别(57.9±12.6)、(65.8±9.6)比(46.4±4.9)μv]、餐后主功率[分别(63.5±13.7)、(68.3±12.6)比(50.6±6.3)μv]均高于正常BMI组(均P<0.001)。重度肥胖组的�Objective To investigate the characteristics of gastric electric rhythm in patients with obesity.Methods Obese patients who were scheduled to undergo weight reduction surgery in Peking Union Medical College Hospital from January 2018 to February 2024 were prospectively included.According to body mass index(BMI),the patients were divided into mild‑to‑moderate obesity group(28 kg/m^(2)≤BMI<40 kg/m^(2))and severe obesity group(BMI≥40 kg/m^(2)).Patients who were going to complete electrogastrography(EGG)with normal BMI(18.5 kg/m^(2)≤BMI<25 kg/m^(2)),without upper gastrointestinal symptoms,gastrointestinal surgery history,and underlying diseases such as diabetes mellitus were included as normal BMI group.The clinical data was recorded and EGG examination and analysis were performed.The gastric electric rhythm characteristics of patients were compared among the three groups.The correlation between BMI and gastric electric rhythm parameters was analyzed.The differences of EGG parameters between obese patients with diabetes mellitus and obese patients without diabetes mellitus were compared.Results A total of 60 obese patients were included,including 25 males and 35 females,whose age were 18.0-59.0(27.6±6.9)years old and BMI were(41.0±7.1)kg/m^(2).There were 30 patients in mild‑to‑moderate obesity group and 30 patients in severe obesity group.Twenty‑four patients were included in normal BMI group,including 11 males and 13 females,whose age were 21.0-42.0(30.7±6.8)years old,and BMI were(22.7±3.1)kg/m^(2),with no difference in age and gender compared with mild‑to‑moderate and severe obesity groups(both P>0.05).EGG results showed that the percentage of normal slow wave before meal(43.2%±20.0%,37.0%±16.9%,respectively,vs 74.6%±13.6%),and the percentage of normal slow wave after meal(31.6%±13.8%,28.5%±11.3%,respectively,vs 68.5%±14.4%)in the mild‑to‑moderate obesity group and the severe obesity group were significantly lower than those in the normal BMI group(all P<0.001).In the mild‑to‑m

关 键 词：肥胖症 体质指数 胃电图 胃电节律 特征 

分 类 号：R589.2[医药卫生—内分泌]