Parkman H P, Hallinan E K, Hasler W L, Farrugia G, Koch K L, Calles J, Snape W J, Abell T L, Sarosiek I, McCallum R W, Nguyen L, Pasricha P J, Clarke J, Miriel L, Lee L, Tonascia J, Hamilton F
Temple University, Philadelphia, PA, USA.
Johns Hopkins University, Baltimore, MD, USA.
Neurogastroenterol Motil. 2016 Dec;28(12):1902-1914. doi: 10.1111/nmo.12893. Epub 2016 Jun 27.
Nausea and vomiting are classic symptoms of gastroparesis. It remains unclear if characteristics of nausea and vomiting are similar in different etiologies of gastroparesis. The aims of this article were as follows: to describe characteristics of nausea and vomiting in patients with gastroparesis and to determine if there are differences in nausea and vomiting in diabetic (DG) and idiopathic gastroparesis (IG).
Gastroparetic patients enrolling in the NIDDK Gastroparesis Registry underwent assessment with history and questionnaires assessing symptoms, quality of life, and a questionnaire characterizing nausea and vomiting.
Of 159 gastroparesis patients (107 IG, 52 DG), 96% experienced nausea, whereas 65% experienced vomiting. Nausea was predominant symptom in 28% and vomiting was predominant in 4%. Nausea was severe or very severe in 41%. PAGI-SYM nausea/vomiting subscore was greater with increased vomiting severity, but not nausea severity in DG than IG. Nausea was related to meals in 71%; lasting most of the day in 41%. Increasing nausea severity was related to decreased quality of life. Nausea often preceded vomiting in 82% of patients and vomiting often relieved nausea in 30%. Vomiting was more common in DG (81%) compared to IG (57%; p = 0.004). Diabetic patients more often had vomiting in the morning before eating, during the night, and when not eating.
CONCLUSIONS & INFERENCES: Nausea is present in essentially all patients with gastroparesis irrespective of cause and associated with decreased quality of life. In contrast, vomiting was more prevalent, more severe, and occurred more often in DG than IG. Thus, characteristics of vomiting differ in IG vs DG.
恶心和呕吐是胃轻瘫的典型症状。目前尚不清楚不同病因的胃轻瘫患者恶心和呕吐的特征是否相似。本文的目的如下：描述胃轻瘫患者恶心和呕吐的特征，并确定糖尿病性胃轻瘫（DG）和特发性胃轻瘫（IG）患者在恶心和呕吐方面是否存在差异。
纳入美国国立糖尿病、消化和肾脏疾病研究所（NIDDK）胃轻瘫登记处的胃轻瘫患者接受了病史评估，并通过问卷评估症状、生活质量以及一份描述恶心和呕吐特征的问卷。
159例胃轻瘫患者（107例IG，52例DG）中，96%经历过恶心，而65%经历过呕吐。恶心为主要症状的占28%，呕吐为主要症状的占4%。41%的患者恶心严重或非常严重。在DG患者中，随着呕吐严重程度增加，PAGI-SYM恶心/呕吐子评分升高，但恶心严重程度则不然，DG患者的该评分高于IG患者。71%的恶心与进餐有关；41%的恶心持续一整天。恶心严重程度增加与生活质量下降有关。82%的患者恶心常先于呕吐出现，30%的患者呕吐常可缓解恶心。与IG患者（57%；p = 0.004）相比，DG患者呕吐更常见（81%）。糖尿病患者更常在晨起未进食前、夜间以及未进食时出现呕吐。
几乎所有胃轻瘫患者均存在恶心，无论病因如何，且与生活质量下降相关。相比之下，呕吐在DG患者中更为普遍、更严重，且比IG患者更常发生。因此，IG和DG患者呕吐的特征有所不同。
