Oba-Kuniyoshi A S, Oliveira J A, Moraes E R, Troncon L E A
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Braz J Med Biol Res. 2004 Jan;37(1):47-53. doi: 10.1590/s0100-879x2004000100007. Epub 2003 Dec 18.
Gastric dysrhythmias, such as tachy- or bradygastria, have been reported in patients with functional dyspepsia (FD), but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG) studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume) or 300 ml (high volume) water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4%) reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1%) presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%). Following the high volume meal, 7 patients (50%) had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0%) was similar (P>0.20) to that in those without symptoms (88.5%; 75.0-100.0%). We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotility-like FD.
胃节律紊乱，如胃动过速或胃动过缓，在功能性消化不良（FD）患者中已有报道，但其在症状产生中的作用尚不确定。这些患者的胃节律紊乱是否可由进食引起的生理性胃扩张诱发也不清楚。我们研究了FD患者在试餐后摄入不同量水后症状与胃节律紊乱之间的关系。14例动力障碍样FD患者和13名健康志愿者接受了配对胃电图（EGG）研究。空腹受试者随机摄入150毫升酸奶加150毫升（少量）或300毫升（大量）水。两项研究均进行了空腹和进食时的EGG检查并监测症状。10例FD患者（71.4%）在少量进食后报告有上腹部不适和腹胀，但只有1例（7.1%）出现异常EGG（主频在2 - 4次/分钟范围内：58%）。大量进食后，7例患者（50%）出现症状，但无一例EGG异常。在任何测试中，FD患者和对照组之间的任何EGG变量均未发现显著差异。在有餐后症状的FD患者中，EGG主频在正常范围内的百分比（中位数，84.6%；范围，76.0 - 100.0%）与无症状患者（88.5%；75.0 - 100.0%）相似（P>0.20）。我们得出结论，胃肌电活动紊乱不太可能在动力障碍样FD患者餐后上腹部不适和腹胀的发生中起作用。
