Leahy A, Besherdas K, Clayman C, Mason I, Epstein O
Department of Gastroenterology, Royal Free Hospital, London, United Kingdom.
Am J Gastroenterol. 1999 Apr;94(4):1023-8. doi: 10.1111/j.1572-0241.1999.01007.x.
Cutaneous electrogastrography records gastric electrical activity and detects gastric arrhythmias. Abnormalities of the electrogastrogram have been described in a variety of disorders, but their specificity and their prevalence in patients with functional gastrointestinal disorders has not been reported. The aim of this study was to assess the specificity of electrogastrography as well as the prevalence and pattern of abnormalities in functional dyspepsia and irritable bowel syndrome.
Electrogastrography was performed in 170 patients with functional dyspepsia, 70 patients with irritable bowel syndrome, 20 patients with gastroesophageal reflux disease, and 30 asymptomatic controls. The abnormal electrogastrogram was defined as <70% normal electrical activity either before or after a test meal.
The electrogastrogram was abnormal in 36% of patients with functional dyspepsia and in 25% with irritable bowel syndrome who complained of concurrent dyspepsia. The electrogastrogram was normal in 93% of asymptomatic controls, 90% of patients with gastroesophageal reflux, and 92% of patients with irritable bowel syndrome who did not complain of dyspepsia. As a group, functional dyspepsia patients had a greater degree of tachygastrias both before (p < 0.02) and after (p < 0.01) a test meal. The electrical frequency after the test meal was also more unstable (p < 0.003).
The electrogastrogram is abnormal in approximately 36% of functional dyspepsia patients and has a specificity of approximately 93%. Electrogastrography defines a subgroup of patients with functional dyspepsia and electrical rhythm disturbance. In irritable bowel syndrome, the electrogastrogram is usually abnormal only if concurrent dyspepsia is present.
皮肤胃电图可记录胃电活动并检测胃心律失常。胃电图异常已在多种疾病中有所描述，但在功能性胃肠疾病患者中的特异性及患病率尚未见报道。本研究旨在评估胃电图在功能性消化不良和肠易激综合征中的特异性、异常情况的患病率及模式。
对170例功能性消化不良患者、70例肠易激综合征患者、20例胃食管反流病患者及30例无症状对照者进行胃电图检查。异常胃电图定义为试餐前后正常电活动均<70%。
功能性消化不良患者中36%胃电图异常，有消化不良症状的肠易激综合征患者中25%胃电图异常。无症状对照者中93%胃电图正常，胃食管反流患者中90%胃电图正常，无消化不良症状的肠易激综合征患者中92%胃电图正常。总体而言，功能性消化不良患者在试餐前后的快速胃动过速程度更高（试餐前p<0.02，试餐后p<0.01）。试餐后的电频率也更不稳定（p<0.003）。
约36%的功能性消化不良患者胃电图异常，特异性约为93%。胃电图可明确一组存在胃电节律紊乱的功能性消化不良患者。在肠易激综合征中，通常仅在并发消化不良时胃电图才会异常。
