肝硬化患者胃排空与小肠通过时间的研究  

Abnormal gastric emptying and small intestinal transition in patients with liver cirrhosis

作　　者：宗晔[1] 王惠吉[1] 李春林[2] 隗彦珍[2] 

机构地区：[1]首都医科大学北京友谊医院消化内科,100050 [2]首都医科大学北京友谊医院核医学科,100050

出　　处：《中华消化杂志》2003年第6期352-354,共3页Chinese Journal of Digestion

摘　　要：目的　研究肝硬化患者胃肠运动变化 ,探讨肝功能、胃肠激素对患者胃肠运动的影响。方法　选择 5 0例肝硬化患者及 14例正常人作为研究对象 ,检测肝硬化患者肝功能 ,按Child Pugh分级将患者分为三组。运用核素法检测所有受试者胃半排时间 (GET1/ 2 )和小肠通过时间 (SITT) ,放免法检测受试者的血浆胃肠激素 :血管活性肠肽 (VIP)、胃动素 (MT)。结果　 5 0例肝硬化患者GET1/ 2与正常对照组间差异无显著性 (P >0 .0 5 ) ,但ChildC级患者GET1/ 2较正常对照、ChildB级、A级均明显延长 (P <0 .0 5 ) ;5 0例肝硬化患者SITT较正常对照明显延长 (P <0 .0 5 ) ,且ChildC级和B级患者SITT较正常对照组和ChildA级患者明显延长 (P <0 .0 5 )。肝硬化患者的凝血酶原时间 (PT)与SITT呈正相关 ,胆碱酯酶 (CHE)与SITT呈负相关。血浆VIP与GET1/ 2和SITT均呈正相关 ,而血浆MT与GET1/ 2和SITT无明显的相关性。结论　肝硬化患者存在胃肠运动障碍 ,肝功能越差 ,胃肠运动异常的程度越重。肝硬化患者胃肠运动受多种因素的影响 ,其中肝储备功能、升高的血浆VIP对胃肠运动起一定的延缓作用 ,而血浆MT与患者的胃肠运动关系不密切。Objective The aim of the study was to evaluate the solid gastric emptying and small intestinal transit time(SITT) and to explain the relationship between the motility disorders and following factors such as the liver function status and gastrointestinal hormones in patients with liver cirrhosis. Methods Fifty patients with liver cirrhosis and 14 age- and sex-matched healthy controls were enrolled in the study. The patients were divided into three groups according to the Child-Pugh's classification. Radionuclide-labelled solid meals were used to evaluate the gastric emptying and SITT. The levels of serum vasoactive intestinal peptide (VIP) and motilin were measured by radioimmunoassay. Results The difference of the half-time for gastric emptying was not statistically significant between the patients with liver cirrhosis and the control subjects (P>0.05), but the significantly delayed gastric emptying was observed in patients of Child's class C compared with controls and the patients of Child's class B and Child's A (P<0.05). SITT was significantly prolonged in the patients with liver cirrhosis as compared with control subjects (P<0.05). SITT were significantly delayed in the patients of Child's class B and Child's C compared with controls and the patients of Child's class A (P<0.05). Prothrombin time (PT) was positively correlated with the SITT, whereas cholinesterase (CHE) was negatively correlated with the SITT. Serum VIP was positively correlated with gastric emptying time and SITT, whereas serum motilin had no significant relation to gastrointestinal motility disorders. Conclusions Patients with liver cirrhosis has compromised gastrointestinal motility. The degree of motility disorder increases with the deterioration of liver function reserve. The abnormal gastrointestinal motility in patients with severe liver cirrhosis may be due to multiple factors including liver failure and abnormal gastrointestinal hormones such as serum VIP. Serum motilin, however, may have no significant relation to abnormal gastr

关 键 词：肝硬化 胃排空时间 小肠通过时间 血管活性肠肽 胃动素 

分 类 号：R575.2[医药卫生—消化系统]