Pienkowski P, Payen J L, Calès P, Monin J L, Gerin P, Pascal J P, Frexinos J
Service de Nutrition et de Gastroentérologie, CHU Rangueil, Toulouse.
Gastroenterol Clin Biol. 1989 Oct;13(10):763-8.
The morphologic features of the gastric mucosa in patients with cirrhosis have been well investigated. The aim of this study was to evaluate its functional disruption by measuring the gastric potential difference. Forty patients were investigated, 12 control subjects and 28 consecutive cirrhotic patients with endoscopically proved congestive gastropathy. Potential difference was measured the morning, on an empty stomach, at least 3 days after endoscopy; the method used a double channel gastric perfused probe placed under fluoroscopy 10 cm above the cardia, and a subcutaneous reference, both connected to a millivoltimeter via gelose agar-KCl bridges. Potential difference was recorded in each case 20 min before (baseline) and after local instillation of lysine acetylsalicylate (500 mg) as a provocative test. Cirrhotic patients had significantly lower basal potential difference than controls (-28.3 +/- 1.5 mV vs -33.8 +/- 1.3mV, p = 0.007). Potential difference was significantly lower in patients with severe gastropathy than in patients with mild gastropathy (-20.5 +/- 2.1 and -28.9 +/- 1.6 mV, respectively, p less than 0.01). After stimulation with acetylsalicylate, the area under curve and the irritability index were greater in patients with gastropathy (81.4 +/- 12.8 vs 41.2 +/- 8.6 mV.min, p = 0.032 and 0.935 +/- 0.19 vs 0.290 +/- 0.07 mV.mV.min, p = 0.022, respectively). These differences were explained by a higher drop in potential difference (delta DPmax/baseline; 28.1 +/- 3 vs 16.1 +/- 3 p. 100, p = 0.006) whereas basal return time remained unchanged (16.2 +/- 2.1 vs 13.7 +/- 2.2 min).(ABSTRACT TRUNCATED AT 250 WORDS)
肝硬化患者胃黏膜的形态学特征已得到充分研究。本研究的目的是通过测量胃电位差来评估其功能紊乱情况。对40名患者进行了调查,其中12名对照受试者和28名经内镜证实患有充血性胃病的连续肝硬化患者。在内镜检查至少3天后的早晨,空腹测量电位差;该方法使用置于贲门上方10厘米处的荧光透视下的双通道胃灌注探头和皮下参考电极,二者均通过琼脂 - 氯化钾桥连接到毫伏计。在每种情况下,在局部滴注赖氨酸乙酰水杨酸酯(500毫克)作为激发试验之前(基线)和之后20分钟记录电位差。肝硬化患者的基础电位差显著低于对照组(-28.3±1.5毫伏对-33.8±1.3毫伏,p = 0.007)。重度胃病患者的电位差显著低于轻度胃病患者(分别为-20.5±2.1和-28.9±1.6毫伏,p<0.01)。用乙酰水杨酸酯刺激后,胃病患者的曲线下面积和应激性指数更大(分别为81.4±12.8对41.2±8.6毫伏·分钟,p = 0.032和0.935±0.19对0.290±0.07毫伏·毫伏·分钟,p = 0.022)。这些差异是由电位差的更大下降(δDPmax/基线;28.1±3对16.1±3 p.100,p = 0.006)解释的,而基础恢复时间保持不变(16.2±2.1对13.7±2.2分钟)。(摘要截于250字)