胃电图:与胃十二指肠测压相关性差,在成人中的临床实用性存疑。
Electrogastrography: poor correlation with antro-duodenal manometry and doubtful clinical usefulness in adults.
作者信息
Abid Shahab, Lindberg Greger
机构信息
Karolinska Institutet, Department of Medicine, Division of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, Stockholm 14186, Sweden.
出版信息
World J Gastroenterol. 2007 Oct 14;13(38):5101-7. doi: 10.3748/wjg.v13.i38.5101.
AIM
To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters.
METHODS
We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years.
RESULTS
We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r=-0.07, P=0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7+/-0.5 vs 4.0+/-0.5) and tachygastric (3.5+/-0.4 vs 3.7+/-0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)].
CONCLUSION
EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.
目的
研究通过胃电图(EGG)测量的电活动与通过十二指肠测压法(ADM)测量的胃收缩活动之间是否存在相关性。我们还研究了是否可以根据EGG参数预测潜在的运动障碍。
方法
我们比较了从EGG测量的21个参数与从ADM测量的8个参数。通过将每个诊断组的EGG参数与其他患者进行比较,测试了EGG识别潜在诊断的能力。该研究包括148例患者和125例女性的记录。他们的中位年龄为45岁(范围17 - 76岁)。
结果
我们发现EGG与ADM之间的相关性较少且较弱。具体而言,反映对进食反应的参数之间的相关性较差(r = -0.07,P = 0.39)。EGG对潜在运动障碍的鉴别能力也较低。慢传输型便秘(STC)患者在正常胃电活动区域(3.7±0.5对4.0±0.5)和快速胃电活动区域(3.5±0.4对3.7±0.4)的餐后功率较低,正常胃电活动时间百分比更低[87.2(56.5 - 100)%对95.7(0 - 100)%],快速胃电活动时间百分比更高[9.3(0 - 33)%对3.5(0 - 100)%],缓慢性胃电活动时间百分比更高[1.8(0 - 20)%对0(0 - 17.1)%]。肠易激综合征患者的正常胃电活动时间百分比更高[96.5(62.5 - 100)%对93.3(0 - 100)%],并且通过不稳定系数测量的主导频率稳定性更高[15(3 - 77)对24(2 - 72)]。
结论
EGG和ADM似乎测量胃运动活动的不同方面,但无法显示空间相关性。EGG的诊断价值较差,但EGG可能对识别STC患者有一定价值。