Furgała Agata, Błaut-Kadzielska Urszula, Stojakowska Magdalena, Dobrek Łukasz, Mazur Marcel, Machowska Anna, Thor Piotr J
Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland.
Folia Med Cracov. 2012;52(1-2):39-55.
Gastric motor functions are disturbed in patients with chronic renal failure (CRF). The aim of this study was to find the relationship between GI symptoms, gastric myoelectrical activity and regulatory peptides (gastrin, motilin, VIP, CCK) in patients with CRF treated with hemodialyses (HD) and peritoneal dialyses (CAPD).
Gastric myoelectric activity was evaluated with cutaneously recorded electrogastrographs (EGGs) measurement in: group A: 23 pts with CRF treated with CAPD, group B: 21 pts treated with HD and group C: 48 matched healthy controls. GI symptoms severity was quantified with specially designed questionnaire. The laboratory evaluation of plasma parameters, such as: gastrin, motilin, VIP and CCK was performed.
The patients with CRF treated with CAPD and HD showed a significantly lower percentage of normal 2-4 cpm wave's rhythm in both fasting (65.3 +/- 29.3% vs 43.5 +/- 35.9% vs 86.4 +/- 10.2%) and fed conditions (72.7 +/- 34.2% vs 69.5 +/- 22.1% vs 89.3 +/- 9.5%) in comparison to controls. In the fasting state, none of the healthy controls had an abnormal EGG, whereas the 27 patients with CRF (61.3%) had an abnormal EGG. In the fed state the 18 patients with CRF (40.9%). No significant increase of the dominant power (PDP) after meal in CRF patients was observed. The plasma concentrations of gastrin, CCK were increased in fasted and fed CRF patients, whereas VIP and motilin only in fed state.
The patients with CRF showed impaired gastric myoelectrical activity in response to food and high levels of GI hormones. Gastric dysmotility and high peptides appears to be partially responsible for GI symptoms.
慢性肾衰竭（CRF）患者的胃运动功能会受到干扰。本研究的目的是找出接受血液透析（HD）和腹膜透析（CAPD）治疗的CRF患者的胃肠道症状、胃肌电活动与调节肽（胃泌素、胃动素、血管活性肠肽、胆囊收缩素）之间的关系。
通过经皮记录胃电图（EGG）测量来评估胃肌电活动，研究对象包括：A组：23例接受CAPD治疗的CRF患者；B组：21例接受HD治疗的患者；C组：48例匹配的健康对照者。使用专门设计的问卷对胃肠道症状的严重程度进行量化。对血浆参数进行实验室评估，如胃泌素、胃动素、血管活性肠肽和胆囊收缩素。
与对照组相比，接受CAPD和HD治疗的CRF患者在空腹（65.3±29.3%对43.5±35.9%对86.4±10.2%）和进食状态下（72.7±34.2%对69.5±22.1%对89.3±9.5%），正常2 - 4次/分钟波节律的百分比显著降低。在空腹状态下，没有健康对照者的EGG异常，而27例CRF患者（61.3%）的EGG异常。在进食状态下，18例CRF患者（40.9%）的EGG异常。未观察到CRF患者进食后主导功率（PDP）有显著增加。空腹和进食的CRF患者血浆胃泌素、胆囊收缩素浓度升高，而血管活性肠肽和胃动素仅在进食状态下升高。
CRF患者对食物的胃肌电活动受损，且胃肠道激素水平较高。胃动力障碍和高肽水平似乎部分导致了胃肠道症状。
