摄食行为对单纯性肥胖症胃排空与自主神经功能的影响  

Feeding behavior affect gastric emptying and autonomic nerve activity in the simple obesity

作　　者：刘红芬[1] 刘丽[2] 常丽丽[1] 范亚坤[3] 

机构地区：[1]石家庄市第一医院消化内科,050011 [2]河北医科大学第二医院消化内科,石家庄050051 [3]石家庄市第一医院干部科,050011

出　　处：《疑难病杂志》2015年第3期247-250,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省卫生厅重点科技研究计划资助项目(No.20090596)

摘　　要：目的观察不同摄食行为单纯性肥胖症胃排空速率和自主神经活动特征,探讨摄食行为与胃排空异常的关系。方法将50例单纯性肥胖症患者根据饮食行为分为暴食症组(A组,n=18)、正常饮食组(B组,n=19)、功能性消化不良组(C组,n=13),并设健康对照组(D组,n=20)。各组进食^(99)Tc^m-DTPA标记的实验餐后采用单光子发射计算机扫描(SPECT)采集胃部图象,计算胃半排空时间及胃排空率。采用十二导联动态心电记录仪记录进餐前30 min、餐后30 min心电信号,分别进行心率变异性分析,时域参数包括RR间期的标准差(SDNN)、相邻正常R-R间期差值的均方根(RMSSD)、24 h内每5 min正常R-R间期标准差的平均值(SDNNindex);频域参数包括超低频功率(VLF)、低频功率(LF)、高频功率(HF)。结果与D组比较,A组胃半排空时间显著缩短、排空率显著增高(P<0.01);B组无明显差异(P>0.05);C组半排空时间明显延迟、排空率下降(P<0.05)。餐前A组RMSSD、SDNN、SDNNindex、VLF、HF、LF高于D组(P<0.05,P<0.01),迷走、交感神经均活跃;B组LF低于D组(P<0.05),交感神经活性低;与餐前相比,餐后D组SDNN、HF降低,SDNNindex、RMSSD、VLF、LF增加,交感神经活跃;A组、B组SDNNindex、SDNN、VLF、LF降低,RMSSD、HF增高(P<0.01),迷走神经明显活跃,交感神经活性降低;C组RMSSD、SDNN降低,VLF、LF、HF增加(P<0.01),交感、迷走神经均活跃。结论单纯性肥胖不同摄食行为者均存在自主神经异常,均存在餐后迷走神经活跃,但其胃排空情况却不同,表明胃排空能是导致肥胖的主要原因之一,但并非惟一因素,自主神经活动可影响胃排空。Objective To observe the effect of different feeding behavior of simple obesity rate of gastric emptying and autonomic nervous activity characteristics,to explore the relationship between dietary behavior and abnormal gastric emptying.Methods According to diet behavior,50 cases of simple obesity patients were divided into bulimia group(group A,n = 18),normal diet group(group B,n = 19),functional dyspepsia group(group C,n =13) and health control group(group D,n =20).All subjects eating meals which contain Tcm DTPA markers,and then using single photon emission computed tomography(SPECT) to scan stomach,calculated gastric emptying half time and gastric emptying rate.Using twelve lead ECG recorder records the ECG signal 30 min before meal,30 min after meal,heart rate variability analysis of time domain parameters including the standard deviation of RR intervals(SDNN),root mean square adjacent normal R/R interval difference(RMSSD),24 hours every 5 minutes R/R interval standard error of the mean(SDNNindex);frequency domain parameters including ultra-low frequency power(VLF),low frequency power(LF),high frequency power(HF) were performed.Results Compared with group D,group A’ s gastric half emptying time is obviously shortened,emptying rate increased significantly(P <0.01);no significant differences of group B(P >0.05);group C’s half emptying time was significantly delayed,emptying rate decreased(P <0.05).Before the meal,group A’s RMSSD SDNN,SDNNindex,VLF,HF,LF higher than that of group D(P <0.05,P <0.01),vagus,sympathetic nerve were active;group B’s LF lower than group D(P <0.05),sympathetic nerve’s activity was low;compared with before the meal,postprandial group D’ s SDNN,HF reduces,SDNNindex,RMSSD,VLF,LF increased,sympathetic nerve was active;group A and group B’s SDNNindex,SDNN,VLF,LF decreased,RMSSD and HF increased,(P <0.01),vagus nerve was active,sympathetic nerve’ s activity reduced;group C’s RMSSD,SDNN were decreased,VLF,LF,HF were increased(P <0.01),sympathetic,vagus nerve were active.Conclu

关 键 词：单纯性肥胖 不同摄食行为 胃排空 自主神经 

分 类 号：R589.2[医药卫生—内分泌]