Sarnelli G, Vos R, Cuomo R, Janssens J, Tack J
Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Am J Gastroenterol. 2001 Apr;96(4):1047-53. doi: 10.1111/j.1572-0241.2001.03520.x.
Gastric barostat studies are increasingly being performed, but their reproducibility and the most suitable study protocol have not been determined. The aim of this study was to verify the reproducibility of gastric sensitivity and accommodation testing in healthy and in dyspeptic subjects, and to compare stepwise and double random staircase distensions.
A total of 13 dyspeptic patients and 25 healthy control subjects underwent two successive studies. Sensory thresholds were assessed on a same-day/different-days protocol, using a stepwise (11/14 healthy subjects and 11/13 patients) or a double random staircase inflation (11/21 healthy subjects). In 10 healthy subjects, both methods were compared. Gastric accommodation was measured on different days in 13 patients and nine healthy subjects. Data (mean +/- SEM) were compared using the paired t test, and individual variability was expressed as the percent coefficient of variation.
In healthy subjects, the thresholds for first perception and for discomfort were highly reproducible (p > 0.05) and the pressure thresholds showed a lower degree of variability than the volumes. Pressure thresholds quantified by stepwise showed lower variability than double random staircase inflation. In the patients, the sensory thresholds were unchanged between the sessions on the same and on different days (p > 0.05). Gastric accommodation also showed excellent reproducibility for both dyspeptic patients and healthy control subjects (p > 0.05).
Both in dyspeptic patients and in healthy control subjects, gastric sensitivity and accommodation quantified by isobaric distensions show excellent reproducibility. Pressure and volume thresholds both are well reproducible, but the former shows less variability. Finally, the simplest stepwise protocol is better than the double random staircase to assess the gastric sensitivity to distension.
胃内压测定研究越来越多，但尚未确定其可重复性以及最合适的研究方案。本研究旨在验证健康受试者和消化不良受试者胃敏感性和适应性测试的可重复性，并比较逐步扩张和双随机阶梯扩张。
总共13名消化不良患者和25名健康对照受试者进行了两项连续的研究。使用逐步扩张法（11/14名健康受试者和11/13名患者）或双随机阶梯充气法（11/21名健康受试者），按照同一天/不同天的方案评估感觉阈值。在10名健康受试者中，对两种方法进行了比较。在不同日期测量了13名患者和9名健康受试者的胃适应性。使用配对t检验比较数据（均值±标准误），个体变异性以变异系数百分比表示。
在健康受试者中，首次感知和不适的阈值具有高度可重复性（p>0.05），压力阈值的变异性低于容量阈值。逐步扩张法量化的压力阈值比双随机阶梯充气法的变异性更低。在患者中，同一天和不同天的感觉阈值在各次测量之间没有变化（p>0.05）。胃适应性在消化不良患者和健康对照受试者中均表现出极好的可重复性（p>0.05）。
在消化不良患者和健康对照受试者中，通过等压扩张量化的胃敏感性和适应性均表现出极好的可重复性。压力和容量阈值均具有良好的可重复性，但前者的变异性较小。最后，在评估胃对扩张的敏感性方面，最简单的逐步扩张方案优于双随机阶梯扩张方案。
