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使用胃电图和体外超声评估克罗恩病患者的胃动力

The use of electrogastrography and external ultrasonography to evaluate gastric motility in Crohn's disease.

作者信息

Kohno Nao, Nomura Masahiro, Okamoto Hiroshi, Kaji Masako, Ito Susumu

机构信息

Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School.

出版信息

J Med Invest. 2006 Aug;53(3-4):277-84. doi: 10.2152/jmi.53.277.

Abstract

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.

摘要

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。

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