胆道闭锁术后患者的胃肌电活动紊乱。

A disturbance of the gastric myoelectric activity in post-operative patients with biliary atresia.

作者信息

Ohtaki Masahiro, Yagi Minoru, Kubota Masayuki, Homma Shinji

机构信息

Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Niigata City, Japan.

出版信息

Pediatr Surg Int. 2004 Feb;20(2):77-82. doi: 10.1007/s00383-003-1091-5. Epub 2004 Jan 14.

DOI:10.1007/s00383-003-1091-5

PMID:14722717

Abstract

BACKGROUND

Abnormalities in gastrointestinal motility have been reported in adult patients with advanced liver disease. However, there have so far been no reports on the gastric myoelectric activity in post-operative patients with biliary atresia (BA).

AIM

The purpose of this study was to evaluate the gastric myoelectric activity in post-operative patients with BA in relation to liver fibrosis.

PATIENTS AND METHODS

Twenty-one post-operative patients with BA, consisting of 6 boys and 15 girls with a mean age of 8.0 years and 6 healthy children (control group) were included in the study. The gastric myoelectric activity was measured by electrogastrography (EGG). The patients with BA were divided into two groups according to the serum hyaluronic acid (HA) level as a marker of liver fibrosis: the fibrotic group (FG, n=11), HA>50 ng/ml and the non-fibrotic group (NF, n=10), HA <==50 ng/ml. All recorded data were spectrally analyzed and any parameters related to changes in the dominant peak frequency (DPF) and its power were investigated. Furthermore, the gastrointestinal symptom scores (GSS) were calculated in patients with dyspeptic symptoms according to the degree of advanced liver fibrosis.

RESULTS

The results showed that 1) the postprandial DPF in the FG tended to be higher than that in the NFG ( p=0.051), 2) the postprandial variability index of the DPF in the FG and NFG were significantly higher than those in the controls ( p<0.05), and 3) the preprandial percentage of normal waves (PNW) in the FG tended to be lower than that in the controls ( p=0.089). The postprandial PNWs in the FG and NFG were significantly lower than those in the controls ( p<0.05). Especially, the postprandial PNW in the FG was significantly lower than that in the NFG ( p<0.05). 4) The power ratio in the FG and NFG were significantly lower than those in the controls ( p<0.05), and 5) the GSSs in the FG were significantly higher than those in the NFG ( p<0.05).

CONCLUSIONS

The gastric myoelectric activity appeared to be disturbed in BA patients associated with portal hypertension and neurohormonal changes due to liver fibrosis.

摘要

背景

已有报道称晚期肝病成年患者存在胃肠动力异常。然而，迄今为止，尚无关于胆道闭锁（BA）术后患者胃肌电活动的报道。

目的

本研究旨在评估BA术后患者的胃肌电活动及其与肝纤维化的关系。

患者与方法

本研究纳入了21例BA术后患者，其中包括6名男孩和15名女孩，平均年龄8.0岁，以及6名健康儿童（对照组）。通过胃电图（EGG）测量胃肌电活动。根据血清透明质酸（HA）水平作为肝纤维化标志物，将BA患者分为两组：纤维化组（FG，n = 11），HA>50 ng/ml；非纤维化组（NF，n = 10），HA<=50 ng/ml。对所有记录的数据进行频谱分析，并研究与主导峰频率（DPF）及其功率变化相关的任何参数。此外，根据肝纤维化进展程度计算有消化不良症状患者的胃肠道症状评分（GSS）。

结果

结果显示，1）FG组餐后DPF倾向于高于NFG组（p = 0.051），2）FG组和NFG组餐后DPF的变异性指数显著高于对照组（p<0.05），3）FG组餐前正常波百分比（PNW）倾向于低于对照组（p = 0.089）。FG组和NFG组餐后PNW显著低于对照组（p<0.05）。特别是，FG组餐后PNW显著低于NFG组（p<0.05）。4）FG组和NFG组的功率比显著低于对照组（p<0.05），5）FG组的GSS显著高于NFG组（p<0.05）。