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胃轻瘫患者的腹痛:与胃轻瘫症状、胃轻瘫病因、胃排空、躯体化和生活质量的关系。

Abdominal Pain in Patients with Gastroparesis: Associations with Gastroparesis Symptoms, Etiology of Gastroparesis, Gastric Emptying, Somatization, and Quality of Life.

机构信息

Gastroenterology Section, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, Philadelphia, PA, 19140, USA.

Johns Hopkins University, Baltimore, MD, USA.

出版信息

Dig Dis Sci. 2019 Aug;64(8):2242-2255. doi: 10.1007/s10620-019-05522-9. Epub 2019 Mar 9.

Abstract

UNLABELLED

Abdominal pain can be an important symptom in some patients with gastroparesis (Gp).

AIMS

(1) To describe characteristics of abdominal pain in Gp; (2) describe Gp patients reporting abdominal pain.

METHODS

Patients with idiopathic gastroparesis (IG) and diabetic gastroparesis (DG) were studied with gastric emptying scintigraphy, water load test, wireless motility capsule, and questionnaires assessing symptoms [Patient Assessment of Upper GI Symptoms (PAGI-SYM) including Gastroparesis Cardinal Symptom Index (GCSI)], quality of life (PAGI-QOL, SF-36), psychological state [Beck Depression Inventory (BDI), State-Trait Anxiety Index (STAI), PHQ-15 somatization scale].

RESULTS

In total, 346 Gp patients included 212 IG and 134 DG. Ninety percentage of Gp patients reported abdominal pain (89% DG and 91% IG). Pain was primarily in upper or central midline abdomen, described as cramping or sickening. Upper abdominal pain was severe or very severe on PAGI-SYM by 116/346 (34%) patients, more often by females than by males, but similarly in IG and DG. Increased upper abdominal pain severity was associated with increased severity of the nine GCSI symptoms, depression on BDI, anxiety on STAI, somatization on PHQ-15, the use of opiate medications, decreased SF-36 physical component, and PAGI-QOL, but not related to severity of delayed gastric emptying or water load ingestion. Using logistic regression, severe/very severe upper abdominal pain associated with increased GCSI scores, opiate medication use, and PHQ-15 somatic symptom scores.

CONCLUSIONS

Abdominal pain is common in patients with Gp, both IG and DG. Severe/very severe upper abdominal pain occurred in 34% of Gp patients and associated with other Gp symptoms, somatization, and opiate medication use. ClinicalTrials.gov Identifier: NCT01696747.

摘要

未加标签

腹痛在一些胃轻瘫(Gp)患者中可能是一个重要症状。

目的

(1)描述 Gp 患者腹痛的特征;(2)描述报告腹痛的 Gp 患者。

方法

对特发性胃轻瘫(IG)和糖尿病性胃轻瘫(DG)患者进行胃排空闪烁显像、水负荷试验、无线动力胶囊和评估症状的问卷研究[患者上消化道症状评估(PAGI-SYM),包括胃轻瘫关键症状指数(GCSI)]、生活质量(PAGI-QOL、SF-36)、心理状态[贝克抑郁量表(BDI)、状态-特质焦虑量表(STAI)、PHQ-15 躯体化量表]。

结果

共纳入 346 例 Gp 患者,其中 212 例为 IG,134 例为 DG。90%的 Gp 患者报告腹痛(89%DG 和 91%IG)。疼痛主要在上腹部或中线中部,表现为痉挛或恶心。346 例 Gp 患者中有 116 例(34%)在 PAGI-SYM 上报告上腹痛严重或非常严重,女性多于男性,但 IG 和 DG 中相似。上腹痛严重程度增加与 GCSI 症状九个严重程度增加、BDI 上的抑郁、STAI 上的焦虑、PHQ-15 上的躯体化、阿片类药物的使用、SF-36 身体成分和 PAGI-QOL 降低有关,但与胃排空延迟或水负荷摄入的严重程度无关。使用逻辑回归,严重/非常严重的上腹痛与 GCSI 评分增加、阿片类药物使用和 PHQ-15 躯体症状评分相关。

结论

腹痛在 Gp 患者中很常见,IG 和 DG 均如此。34%的 Gp 患者出现严重/非常严重的上腹痛,并与其他 Gp 症状、躯体化和阿片类药物使用有关。临床试验编号:NCT01696747。

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