功能性消化不良患者症状分型、胃排空功能、胃肠激素水平的相关性  

Relationships among symptom subgroups,gastric emptying and blood gut hormones in patients with functional dyspepsia

作　　者：唐红卫[1] 黄裕新[1] 徐海峰[2] 高巍[1] 周润锁 尚磊[4] 王庆莉[1] 高峰[2] 安晓丽[2] 

机构地区：[1]中国人民解放军第四军医大学唐都医院消化内科,陕西省西安市710038 [2]中国人民解放军第四军医大学唐都医院核医学科,陕西省西安市710038 [3]中国人民解放军第四军医大学唐都医院核医学院,陕西省西安市710038 [4]中国人民解放军第四军医大学预防医学系卫生统计学教研室,陕西省西安市710033

出　　处：《世界华人消化杂志》2003年第11期1715-1719,共5页World Chinese Journal of Digestology

摘　　要：目的:通过放射性核素胃排空检测及血中胃肠激素检测,了解功能性消化不良(functional dyspepsia,FD)患者症状分型、胃排空和胃肠激素的相互关系,探讨其发病机制.方法:以 FD 患者为观察对象.依据罗马Ⅱ标准,将符合纳入标准的患者分为三个临床亚型,每型患者随机取10人为一组,并以10名健康志愿者作为对照组,同步观察胃排空及相关胃肠激素的变化.胃排空检测后,再将30例 FD 患者分为2组,胃排空正常组和胃排空延迟组.通过^(99m)Tc 标记的固体餐检测胃排空,应用放射免疫法测定外周血中胃动素(motilin,MTL),生长抑素(somatostatin,SS),P物质(substance P,SP)的含量.应用硝酸还原酶法测定外周血中一氧化氮(nitric oxide,NO)的含量.结果:溃疡样型组40%胃排空延缓,胃半排空时间(GET_(1/2))及各时间段胃排空率(GE%)与健康对照组比较无显著差异(P>0.05),与动力障碍样型组、非特异性型组比较亦无显著差异(P>0.05);外周血 SS 升高(P<0.05),MTL,SP,NO 与健康对照组比较无显著性差异(P>0.05).动力障碍样型组70%胃排空延缓,GET_(1/2)延长(P<0.05),GE%15min,30min 与健康对照组比较差别不显著(P>0.05),45min 及45min 以后各时间段减低(45min,P<0.05;60min,P<0.05;90min,P<0.01;120min,P<0.01);外周血 SS 升高(P<0.05),MTL、SP、NO 与健康对照组比较无显著性差异(P>0.05).非特异性型组70%胃排空延缓,GET_(1/2)延长(P<0.05),GE%15min、30min 与健康对照组比较差别不显著(P>0.05),45min 及45min 以后各时间段减低(45min,P<0.05;60min,P<0.05;90min,P<0.01;120min,P<0.01);外周血 SS升高(P<0.05),MTL,SP,NO 与健康对照组比较无显著性差异(P>0.05).FD 胃排空正常组与健康对照组比较外周血SS 升高(P<0.05),MTL,SP,NO 无显著性差异(P>0.05),FD 胃排空延迟组与健康对照组比较外周血 SS,NO 升高(P<0.05),MTL 降低(P<0.05),SP 无显著性差异(P>0.05).结论:FD 患者有明显的胃动力障碍,以动力障碍样型和非特异型AIM:To study the relationships among symptom subgroups, gastric emptying and gastrointestinal hormones in patients with functional dyspepsia(FD)and to explore pathogenesis of FD. METHODS:The patients with FD were divided into 3 sub- groups according to the Rome Ⅱ criteria and 10 cases were selected randomly from each subgroup.Ten healthy sub- jects served as control.Thus 4 subgroups were set up, including the ulcer-like dyspepsia group(10 cases),the dysmotility-like dyspepsia group(10 cases),the unspeci- fied dyspepsia group(10 cases)and the control group(10 healthy subjects).Changes of radionuclide gastric emptying and blood levels of relevant gastrointestinal hormones were observed synchronously.After gastric emptying was measured,the 30 cases of FD were divided into 2 groups: the normal gastric emptying group and the delayed gastric emptying group.Gastric emptying was recorded by ^(99m)Tc- labelled solid food.Changes in motilin(MTL),somatostatin (SS),substance P(SP)and nitric oxide(NO)contents in pe- ripheral blood were determined by radioimmunoassay and nitrate reductase technique. RESULTS:In the ulcer-like group,40% patients had gas- tric emptying delay while the half gastric emptying time (GET_(1/2))and gastric emptying rate(GE%)at every time- point did not show significant changes(P<0.05)compared with control group and the other two subgroups of FD. The levels of SS in peripheral blood were increased sig- nificantly(P<0.05).However,the levels of MTL,SP,NO did not show significant changes(P<0.05)compared with control group.In the dysmotility-like group,70% patients had gastric emptying delay,meanwhile,GET_(1/2) was pro- longed significantly(P<0.05),and GE% was decreased significantly(15 min,P>0.05;30 min,P>0.05;45 min, P<0.05;60 min,P<0.05;90 min,P<0.01;and 120 min, P<0.01,respectively).Levels of SS in peripheral blood were increased significantly(P<0.05),whereas levels of MTL,SP,NO did not show significant changes(P>0.05). In the unspecified group,70% of patients had gastric emptying delay,meanwhile,GET_

关 键 词：功能性消化不良 症状 临床分型 胃排空功能 胃肠激素 相关性 放射免疫法 硝酸还原酶法 外周血 

分 类 号：R57[医药卫生—消化系统]