Borges Cláudio Marins Rocha, Secaf Marie, Troncon Luiz Ernesto de Almeida
Arq Gastroenterol. 2013 Oct-Dec;50(4):270-6. doi: 10.1590/S0004-28032013000400006.
Gastroparesis is defined by delayed gastric emptying without mechanical obstruction of the gastroduodenal junction, which has been increasingly investigated. Nevertheless, knowledge on the relationships between etiology, symptoms and degree of delayed gastric emptying is limited.
The demographic, clinical and etiological features of Brazilian patients with gastroparesis were studied and the relationships between these findings and the severity of gastric emptying were determined.
This is a retrospective study of medical records of 41 patients with symptoms suggestive of gastroparesis admitted between 1998 and 2011, who had evidence of abnormally delayed gastric emptying on abdominal scintigraphy. Cases with idiopathic gastroparesis were compared with those of patients with neurologic disorders or diabetes mellitus, in whom autonomic neuropathy is likely to occur.
The majority of the patients were women (75.6%) with a median age of 41 years and a long-term condition (median: 15 years). Twelve patients (29.3%) had a body mass index of less than 20 kg/m2. The most common presenting symptoms were dyspepsia (53.6%), nausea and vomiting (46.3%), weight loss (41.4%) and abdominal pain (24.3%). Regarding etiology, 16 patients had digestive disorders including idiopathic gastroparesis (n = 12), 12 had postoperative conditions, 11 had diseases of the nervous system, five had diabetes mellitus and in three cases gastroparesis was associated to a variety of conditions. In the majority of patients (65.8%) gastric emptying was severely delayed. There was no association between etiology of gastroparesis, type of presenting symptoms and the degree of delay in gastric emptying. Gastroparesis patients with proven (neurological conditions) or presumed (diabetes) nervous system involvements were significantly younger (P = 0.001), had more recent symptom onset (P = 0:03) and a trend towards more severe gastric empty (P = 0:06). There were no significant differences between this subgroup of patients and that comprising cases of idiopathic gastroparesis regarding any of the variables studied.
The demographic, clinical and etiological characteristics of Brazilian patients with gastroparesis are quite varied, but there is a predominance of women with long-standing symptoms and marked delay in gastric emptying. The type of presenting symptoms and the degree of delay in gastric emptying do not predict the etiology of gastroparesis. However, severely delayed gastric emptying in younger patients with recent symptom onset should raise the suspicion of impaired neural control of gastro-duodenal motility.
胃轻瘫的定义为胃排空延迟且不存在胃十二指肠交界处的机械性梗阻，对此的研究日益增多。然而，关于病因、症状与胃排空延迟程度之间关系的了解有限。
研究巴西胃轻瘫患者的人口统计学、临床和病因学特征，并确定这些发现与胃排空严重程度之间的关系。
这是一项对1998年至2011年间收治的41例有胃轻瘫症状提示的患者病历的回顾性研究，这些患者在腹部闪烁扫描中有胃排空异常延迟的证据。将特发性胃轻瘫患者与可能发生自主神经病变的神经系统疾病或糖尿病患者进行比较。
大多数患者为女性（75.6%），中位年龄41岁，病程较长（中位值：15年）。12例患者（29.3%）的体重指数低于20kg/m²。最常见的症状为消化不良（53.6%）、恶心和呕吐（46.3%）、体重减轻（41.4%）和腹痛（24.3%）。关于病因，16例患者有消化系统疾病，包括特发性胃轻瘫（n = 12），12例有术后情况，11例有神经系统疾病，5例有糖尿病，3例胃轻瘫与多种情况相关。大多数患者（65.8%）胃排空严重延迟。胃轻瘫的病因、症状类型与胃排空延迟程度之间无关联。已证实（神经系统疾病）或推测（糖尿病）有神经系统受累的胃轻瘫患者明显更年轻（P = 0.001），症状出现时间更近（P = 0.03），且有胃排空更严重的趋势（P = 0.06）。在研究的任何变量方面，该亚组患者与特发性胃轻瘫患者亚组之间均无显著差异。
巴西胃轻瘫患者的人口统计学、临床和病因学特征差异很大，但以有长期症状且胃排空明显延迟的女性居多。症状类型和胃排空延迟程度不能预测胃轻瘫的病因。然而，近期出现症状的年轻患者胃排空严重延迟应引起对胃十二指肠动力神经控制受损的怀疑。
