Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, California 94305-5187, USA.
Clin Gastroenterol Hepatol. 2011 Jul;9(7):567-76.e1-4. doi: 10.1016/j.cgh.2011.03.003. Epub 2011 Mar 11.
BACKGROUND & AIMS: Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics.
We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry.
Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period.
Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature--it might be a separate clinical entity.
胃排空正常的慢性恶心和呕吐是一种尚未被充分了解的综合征；我们分析了其特征。
我们收集并分析了 6 个中心的 425 例慢性恶心和呕吐患者的数据，这些患者是由美国国立糖尿病、消化和肾脏疾病研究所胃轻瘫注册研究中的胃轻瘫临床研究联盟纳入的。
在这些患者中，319 例（75%）存在延迟排空，通过标准化低脂餐的结果来定义，106 例存在胃排空正常。有或无延迟排空的患者在年龄、性别或种族方面没有差异，尽管胃排空正常的患者不太可能患有糖尿病。两组之间的恶心、干呕、呕吐、胃部饱胀、无法完成进食、餐后感觉过饱、食欲减退、腹胀、以及明显增大的胃部等症状严重程度指数相似。两组在医疗保健利用、生活质量指数、抑郁或特质焦虑评分方面没有差异。然而，延迟胃排空的患者的状态焦虑评分略高。两组患者的总胃轻瘫主要症状指数评分与餐后 2 或 4 小时的胃潴留均无相关性。该综合征不能用罗马 III 诊断标准中慢性特发性恶心和功能性呕吐的独立标准充分捕捉到。除了极少数例外，在 48 周随访期间，诊断仍然稳定。
胃排空正常的恶心和呕吐患者代表了一个重大的医疗问题，在很大程度上与胃轻瘫患者无法区分。这种综合征在医学文献中没有分类——它可能是一种单独的临床实体。
