Kamiya Takeshi, Kobayashi Yuka, Hirako Makoto, Misu Naoko, Nagao Toshihiro, Hara Michiko, Matsuhisa Eriko, Ando Takashi, Adachi Hiroshi, Sakuma Nagahiko, Kimura Genjiro
Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
J Smooth Muscle Res. 2002 Apr;38(1-2):1-9. doi: 10.1540/jsmr.38.1.
The existence of abnormal gastric motility in gastric ulcer disease remains controversial. The aim of this study was to characterize gastric motility in patients with recurrent gastric ulcers. Studies were performed in 10 control subjects and in 24 patients with recurrent active gastric ulcer disease as diagnosed by gastrointestinal endoscopy. Gastric motility was evaluated by cutaneous electrogastrography (EGG) and by gastric semi-liquid meal emptying. The EGG was recorded before and after ingestion of a test meal containing 20 mg/kg of acetaminophen. Patients with a dominant EGG frequency of greater than 0.06 Hz were defined as tachygastria, while those with a frequency of less than 0.04 Hz were defined as bradygastria. A transient frequency decrease, called postprandial dip (PD), was identified visually. The degree of gastric emptying was determined from the serum acetaminophen concentration 45 minutes after the meal. Control subjects showed no irregularity in their dominant EGG frequency in tither fasting or postprandial states. PD was observed in 8 control subjects. In patients presenting with active gastric ulcers, abnormal patterns in the dominant EGG frequency (either as tachygastria or bradygastria) were observed in 14 of the 24 patients when fasting and in 15 of them in the postprandial state. After successful treatment, the number of patients with abnormal patterns in their dominant EGG frequency remained unchanged, while PD was observed in 11 patients. No significant difference was observed in the EGG power ratio as a result of successful treatment. Gastric emptying was significantly delayed compared with controls in both the active and healed stages. These findings suggest that abnormal gastric motility, including gastric electrical abnormalities and delayed gastric emptying, plays an important role in the pathophysiology of recurrent gastric ulcers.
胃溃疡疾病中胃动力异常的存在仍存在争议。本研究的目的是描述复发性胃溃疡患者的胃动力特征。对10名对照受试者和24名经胃肠内镜诊断为复发性活动性胃溃疡疾病的患者进行了研究。通过皮肤胃电图（EGG）和胃半流质餐排空来评估胃动力。在摄入含20mg/kg对乙酰氨基酚的试验餐前后记录EGG。EGG主频大于0.06Hz的患者被定义为胃动过速，而频率小于0.04Hz的患者被定义为胃动过缓。通过肉眼识别出一种短暂的频率下降，称为餐后波谷（PD）。根据餐后45分钟时血清对乙酰氨基酚浓度确定胃排空程度。对照受试者在空腹或餐后状态下的EGG主频均无异常。8名对照受试者观察到了PD。在患有活动性胃溃疡的患者中，24名患者中有14名在空腹时观察到EGG主频异常模式（胃动过速或胃动过缓），15名在餐后状态下观察到。成功治疗后，EGG主频异常模式的患者数量保持不变，而11名患者观察到了PD。成功治疗后，EGG功率比未观察到显著差异。在活动期和愈合期，胃排空均较对照显著延迟。这些发现表明，包括胃电异常和胃排空延迟在内的异常胃动力在复发性胃溃疡的病理生理学中起重要作用。
