van den Elzen B D, Bennink R J, Holman R, Tytgat G N, Boeckxstaens G E
Departments of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
Neurogastroenterol Motil. 2007 Dec;19(12):968-76. doi: 10.1111/j.1365-2982.2007.00971.x. Epub 2007 Jul 18.
The water drink test is a good tool to evoke dyspeptic symptoms. To what extent these symptoms are related to altered gastric distribution is not clear. Therefore, we determined gastric volumes after a drink test using SPECT. After a baseline scan 20 healthy volunteers (HV) and 18 patients with functional dyspepsia (FD) underwent a drink test (100 mL min(-1)) followed by five scans up to 2 h. Dyspeptic symptoms were scored before every scan. A Wilcoxon signed rank test (P < 0.05) and a mixed effects model were used for statistical analyses. Fasting volumes were significantly higher in FD compared to HV for total, proximal and distal stomach (P < 0.001). Functional dyspeptic patients ingested significantly less water (P < 0.001) and had an impaired filling of the distal part of the stomach (P = 0.001) after the drink test. In FD, bloating (prox. 80%, dist. 56%), pain (prox. 87%, dist. 62%) and fullness (prox. 80%, dist. 59%) were determined more by proximal stomach volume rather than distal stomach volume. These data suggest that drinking capacity is mainly determined by antral volume, with a reduced antral filling in FD compared to HV. The persisting symptoms of bloating, pain and fullness in FD are predominantly associated with proximal stomach volume.
饮水试验是诱发消化不良症状的一种良好工具。这些症状与胃内分布改变的相关程度尚不清楚。因此，我们使用单光子发射计算机断层扫描（SPECT）在饮水试验后测定胃容量。在进行基线扫描后，20名健康志愿者（HV）和18名功能性消化不良（FD）患者接受了饮水试验（100 mL min⁻¹），随后在2小时内进行了5次扫描。在每次扫描前对消化不良症状进行评分。采用Wilcoxon符号秩检验（P < 0.05）和混合效应模型进行统计分析。FD患者的空腹胃容量在胃总体积、胃近端和胃远端均显著高于HV（P < 0.001）。功能性消化不良患者在饮水试验后摄入的水量显著减少（P < 0.001），且胃远端的充盈受损（P = 0.001）。在FD患者中，腹胀（近端80%，远端56%）、疼痛（近端87%，远端62%）和饱腹感（近端80%，远端59%）更多地由胃近端容量而非胃远端容量决定。这些数据表明，饮水能力主要由胃窦容量决定，与HV相比，FD患者的胃窦充盈减少。FD患者持续存在的腹胀、疼痛和饱腹感症状主要与胃近端容量有关。
