尿毒症患者胃肠运动功能障碍  

Dysfunction of gastrointestinal motility in uremic patients

作　　者：黄雯[1] 张建忠[1] 王雁[1] 张稳[1] 丁燕[1] 万小平[1] 

机构地区：[1]首都医科大学北京同仁医院内科,北京100730

出　　处：《基础医学与临床》2003年第2期211-215,共5页Basic and Clinical Medicine

摘　　要：为探讨尿毒症患者胃肠运动功能障碍的特点 ,应用胃肠测压技术对 2 6名尿毒症患者 ,5 1名糖尿病患者 ,16名健康自愿者进行了消化间期移行性复合运动 (MMC)检测 ,连续测定 2 4 0min ;应用放射免疫法检测了上述人员的空腹血浆胃动素水平 ;有 8名尿毒症患者进行了电子胃镜检查。结果表明 :①尿毒症患者MMCⅠ期、Ⅱ期出现的比例明显高于对照组的 13 3% ,总计达 73 1% (P <0 0 1) ,尿毒症组有MMCⅢ期者仅 19 2 % ,明显低于正常对照组(78 0 % ,P <0 0 1)。②在有MMCⅢ期者中 ,尿毒症组胃窦和十二指肠的收缩频率明显低于正常对照组和糖尿病组 (均P <0 0 5 ) ,但胃窦和十二指肠MMCⅢ期的收缩幅度则正常或较高。③尿毒症组空腹血浆胃动素水平明显高于正常对照组和糖尿病组 (均P <0 0 0 1) ,④ 8名行胃镜检查的尿毒症患者中 ,6人为慢性浅表性胃炎 ,2人为贫血性胃改变。提示 :尿毒症患者存在胃肠运动功能障碍 。To investigate the characteristics of the disfunction of gastrointestinal motility in uremic patients. The migrating motor complex(MMC) of 26 uremic patients, 51 diabetics and 16 healthy volunteers were examined by gastrointestinal manometry technology. The plasma motilin in empty stomach was detected by radioimmunoassay in all preceding patients. 8 uremic patients were checked by electronic gastroscope. The results showed: (1) The ratio of phase Ⅰ and Ⅱ of MMC increased in uremic patients (73.1%) as compared with that in the normal controls (13.3%, P <0.01). Only 19.2% of uremic patients had normal phase Ⅲ of MMC, which was signficantly lower than that in the normal ontrols (78.0%, P <0.01). (2) Among the patients of phase Ⅲ MMC the contractive frequency in pyloric part and duodenum was markedly lower in the uremic patients than that in the controls and the diabetic group ( P <0.05, respectively), but the range of contraction was normal or even higher. (3) The level of fasting plasma motilin in uremic patients was notably higher than that from other two groups ( P <0.001, respectively). (4) In the uremic patients detected by gastroscope, 6 showed chronic superficial gastritis and 2 showed anemic alteration of stomach. The results demonstrated the disfunction of gastrointestinal motility existing in uremic patients which mainly displayed in the abmormality of MMC and hypermotilinemia.

关 键 词：尿毒症 胃肠运动功能障碍 放射免疫法 胃肠测压技术 胃动素 

分 类 号：R692.5[医药卫生—泌尿科学] R57[医药卫生—外科学]