代谢综合征患者进食后胃动力调节功能的胃肠超声造影研究  

Gastrointestinal contrast-enhanced ultrasound study on gastric motility regulation function after eating in patients with metabolic syndrome

作　　者：刘颜州 岳文胜[1] 杨航[1] 张曦月 邹媛[1] LIU Yan-zhou;YUE Wen-sheng;YANG Hang;ZHANG Xi-yue;ZOU Yuan(Department of Ultrasound,Affiliated Hospital of North Sichuan Medical College,Nanchong Key Laboratory of Medical Ultrasound Engineering,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院附属医院超声科超声医学工程南充市重点实验室,四川南充637000

出　　处：《中国临床医学影像杂志》2025年第4期250-255,共6页Journal of China Clinic Medical Imaging

基　　金：四川省科技厅应用基础项目(2019YJ0708);川北医学院附属医院科研发展计划项目(2022JC023)。

摘　　要：目的:探讨胃肠超声造影评估代谢综合征(MS)患者进食后胃动力调节功能的价值。方法:纳入2023年10月—2024年7月于我院就诊的52例MS患者为实验组,选取同期48名健康志愿者作为对照组。应用胃肠超声造影评估组间食欲标准化视觉模拟(VAS)评分,并进行消化道症状评定量表(GSRS)评分。测量受试者口服500 mL胃肠超声造影剂后即刻最大近端胃面积(S1)、最大胃窦舒张面积(S2),计算10~30 min各时间点近端胃、远端胃、胃窦部胃排空率(GER)、胃动力指数(MI)、胃窦面积变化(ΔS)及胃窦收缩幅度(ACA)等胃动力参数,收集受试者临床资料及患者实验室指标,分析胃动力参数与实验室指标的相关性。结果:组间VAS比较,差异无统计学意义(P>0.05),MS组GSRS高于对照组,差异有统计学意义(P<0.05)。MS组各时间点近端胃、远端胃及胃窦部GER均低于对照组(P<0.05);胃动力参数比较显示,MS组胃蠕动频率、胃蠕动波峰强度、胃壁增厚率、MI、10~20 min ACA、胃蠕动波速度(V)均低于对照组,而S2、30 minΔS均高于对照组(P<0.05);MS组及对照组ACA达峰时间分别在30 min时及10 min时占比最高,差异有统计学意义(P<0.05)。MS组空腹胰岛素(FINS)与V呈负相关;甘油三酯与ΔS及20~30 min ACA呈负相关;总胆固醇与S1、S2、30 minΔS呈负相关;高密度脂蛋白胆固醇与S1呈负相关;极低密度脂蛋白胆固醇与S1、S2、20~30 minΔS呈负相关(均P<0.05)。结论:MS患者表现为胃动力功能下降、胃排空延迟及ACA达峰时间延迟,GSRS评分更高,其FINS及血脂水平与胃动力参数具有相关性,胃肠超声造影可对MS患者的胃动力调节功能进行定量评价,具有临床应用价值。Objective:To explore the value of gastrointestinal contrast-enhanced ultrasound in evaluating gastric motility regulation function after eating in patients with metabolic syndrome(MS).Methods:Fifty-two patients with MS who were admitted to our hospital were selected from October 2023 to July 2024,and 48 healthy volunteers were selected as the control group at the same period.Gastrointestinal ultrasound contrast was used to assess the standardized Visual Analog Scale(VAS)score for intergroup appetite of participants.Additionally,the Gastrointestinal Symptom Rating Scale(GSRS)was scored.We measured the maximum proximal gastric area(S1)and maximum gastric sinus dilation area(S2)of subjects instantly after drinking the 500 mL contrast agent,calculated gastric motility parameters such as proximal,distal and antral gastric emptying rate(GER),gastric motility index(MI),antral gastric area change(ΔS),and antral contraction amplitude(ACA)at each time point of 10~30 min.We also collected clinical data of subjects and laboratory indicators of patients,and analyzed the correlation between gastric motility parameters and laboratory indicators.Results:There was no statistically significant difference in VAS comparison between groups(P>0.05),the GSRS scores of MS group were higher than the control group and the difference was statistically significant(P<0.05).The GER of the proximal,distal,and antral parts of the MS group were lower than those of the control group at all time points(P<0.05).Comparison of gastric motility parameters showed that the MS group had lower gastric peristalsis frequency,gastric peristalsis peak intensity,gastric wall thickening rate,MI,ACA at 10~20 min,and gastric peristalsis wave velocity(V)than the control group,while the S2 and 30 minΔS were higher than those in the control group(P<0.05).The peak time of ACA in the MS group and the control group was highest at 30 minutes and 10 minutes,respectively,and the difference was statistically significant.Fasting insulin(FINS)in the MS group is negatively

关 键 词：代谢综合征 超声检查 

分 类 号：R442.8[医药卫生—诊断学] R445.1[医药卫生—临床医学]