Kohno Nao, Nomura Masahiro, Okamoto Hiroshi, Kaji Masako, Ito Susumu
Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School.
J Med Invest. 2006 Aug;53(3-4):277-84. doi: 10.2152/jmi.53.277.
Although Crohn's disease is associated with various digestive symptoms, there have been few reports on gastric motility. In this study, we conducted a study of gastric motility in Crohn's disease using 20 healthy subjects (N group) and 15 patients with Crohn's disease (C group) by electrogastrography (EGG) using a Nipro electrogastrograph. An EGG was recorded for 30 minutes in a fasting state and after ingestion of 300 ml of a liquid meal. As an index of gastric emptying, the rate of change in the cross-sectional area of the gastric antrum was measured 1 and 15 minutes after ingestion of the liquid meal by external ultrasonography. In an EGG frequency analysis, waveforms with a peak of 3 cycles/minute (cpm) were noted in the N group, and the peak amplitude increased significantly after the ingestion of food. In the C group, division of the normal-gastria component was noted after the ingestion of food in 5 patients (33.3%). In a comparison of the peak amplitudes of fasting brady-gastria, normal-gastria, and tachy-gastria between the N and C groups, the peak amplitude was significantly increased in normal-gastria in the N group, and in brady-gastria and tachy-gastria in the C group. In a comparison of the rates of food ingestion-induced changes in the peak amplitudes for brady-gastria, normal-gastria, and tachy-gastria between the N and C groups, the peak amplitudes were significantly increased in normal-gastria in the N group, but not in the C group. In the case of gastric emptying investigated by external ultrasonography, the rate of food ingestion-induced change in the cross-sectional antrum area was significantly lower in the C group (50.5+/-9.2%) than in the N group (65.0+/-8.5%). For gastrointestinal motility, a 3 cpm normal-gastria represents efficient gastric motility. In the C group, the peak amplitudes of brady-gastria and tachy-gastria were significantly increased, but were low in normal-gastria in the fasting EGG, postprandial division of the normal-gastria component was noted, and the rate of food ingestion-induced increase in the normal-gastria peak amplitude was significantly lower than that in the N group, suggesting that patients with Crohn's disease have a functional abnormality in, not only the small and large intestine, but also the stomach.
虽然克罗恩病与多种消化症状相关,但关于胃动力的报道却很少。在本研究中,我们使用Nipro胃电图仪,通过胃电图(EGG)对20名健康受试者(N组)和15名克罗恩病患者(C组)进行了胃动力研究。在空腹状态下以及摄入300毫升流食后,记录30分钟的胃电图。作为胃排空的指标,在摄入流食后1分钟和15分钟,通过外部超声测量胃窦横截面积的变化率。在胃电图频率分析中,N组记录到峰值为3次/分钟(cpm)的波形,进食后峰值幅度显著增加。在C组中,5名患者(33.3%)进食后出现正常胃电成分分离。在比较N组和C组空腹慢胃电、正常胃电和快胃电的峰值幅度时,N组正常胃电的峰值幅度显著增加,而C组慢胃电和快胃电的峰值幅度显著增加。在比较N组和C组进食引起的慢胃电、正常胃电和快胃电峰值幅度变化率时,N组正常胃电的峰值幅度显著增加,而C组没有。在通过外部超声检查胃排空的情况下,C组(50.5±9.2%)进食引起的胃窦横截面积变化率显著低于N组(65.0±8.5%)。对于胃肠动力,3 cpm的正常胃电代表有效的胃动力。在C组中,慢胃电和快胃电的峰值幅度显著增加,但空腹胃电图中正常胃电的幅度较低,进食后出现正常胃电成分分离,进食引起的正常胃电峰值幅度增加率显著低于N组,这表明克罗恩病患者不仅在小肠和大肠存在功能异常,胃也存在功能异常。