功能性消化不良患者体表胃电类型及其临床意义  

Electrogastrograph of patients with functional dyspepsia and its clinical significance

作　　者：蓝宇[1] 柯美云[1] 王智凤[1] 张利[1] 陈艳敏[1] 

机构地区：[1]中国医学科学院协和医科大学北京协和医院消化内科

出　　处：《基础医学与临床》2003年第3期322-327,共6页Basic and Clinical Medicine

摘　　要：研究功能性消化不良 (FD)患者胃电活动的形式及其在FD发病中的意义 ,了解胃电活动能否判定FD患者胃功能状况及指导治疗。记录并分析 10 0例FD患者和 5 0名正常人餐前 30分钟及餐后 6 0分钟体表胃电 ,同时进行胃排空检查。发现 (1) 6 5 %FD患者在餐前和 或餐后有胃电节律异常 ;(2 )胃电活动有餐前节律异常 (14 % )、餐后节律异常 (15 % )、餐前餐后节律均异常 (36 % )、餐前餐后节律均正常 (35 % )四种类型。 (3)胃电紊乱的类型有胃动过缓、胃动过速及混合型。部分餐后胃电节律正常化 ,另一些由正常转为异常。 (4 )缓慢节律百分比 (B % ) >5 0 %的患者中 ,5h胃排空率与胃电正常节律百分比、PR呈正相关 ,与B %呈负相关。结论是 :FD患者有胃电节律异常 ,并观察到 4种胃电活动的方式 ,表明FD胃动力紊乱有不同的病理生理学基础 ,可指导治疗 ;To investigate the pattern of gastric myoelectric activity (GMA), the typing of dysrhythmia and their role in pathophysiology of functional dyspepsia. 100 FD patients and 50 health subjects were included. Electrogastrogram(EGG) was used for recording 30 min during fasting and 60 min after a test meal. Five hour gastric emptying(GE) was examined with radiopaque marker at same time. Normal slow wave between 2.4 to 3.7cpm was analyzed with computer. The percentage of normal slow wave less than 65% was defined as dysrhythmia. The result revealed that (1)65% cases showed dysrhythmia in fasting and/or postprandial stages. There were 4 patterns of GMA, i.e, dysrhythmia occured only during pre meal (14%), dysrhythmia only during post meal (15%), dysrhythmia in both pre and post meal (36%), and normal rhythme (35%). (2)Power ratio(PR) in the 4 groups were 4.60±0.88, 2.38±0.62, 1.60±0.30 and 2.28±0.53, respectively. PR in those cases with preprandial dysrhythmia were higher than other patterns( P <0.05), (3)There were more bradygastria during fasting (50%) in FD patients with dysrhythmia. (4)Different effects of meal on gastric electical rhythm. Most of cases remained the same type of dysrhythmia in postprandial. Some with preprandial dysrhythmia normalized in postprandial stage. (5) The percentage of normal slow waves and PR had positive correlation, and the percentage of bradygastria(B%) was negative correlated with 5h GE when B%>50%. It is concluded that (1)Dysrhythmia was very common in patients with FD. Bradygastria was the main type of dysrhythmia. (2) There are 4 types of GMA in FD which have different pathophysiological basis and benifict the clinical management. (3)There is a correlation between EGG parameters and 5h GE in severe bradygastria.

关 键 词：功能性消化不良 胃电活动 临床意义 胃排空 

分 类 号：R57[医药卫生—消化系统]