Momma Eri, Koeda Mai, Tanabe Tomohide, Kanai Saori, Hoshikawa Yoshimasa, Hoshino Shintaro, Kawami Noriyuki, Kaise Mitsuru, Iwakiri Katsuhiko
Department of Gastroenterology Nippon Medical School, Graduate School of Medicine Tokyo Japan.
JGH Open. 2021 Apr 7;5(5):614-621. doi: 10.1002/jgh3.12544. eCollection 2021 May.
Although one of the causes of dyspeptic symptoms in functional dyspepsia patients is gastric hypersensitivity, there is currently no routine endoscopic gastric hypersensitivity test. We developed a new endoscopic method for gastric hypersensitivity testing. The aim of the present study was to investigate whether this method is useful for evaluating gastric hypersensitivity in drug-resistant functional dyspepsia patients who were strongly suspected of having gastric hypersensitivity.
Twenty-seven drug-resistant functional dyspepsia patients and 27 nonfunctional dyspepsia patients were recruited. Gastric pressure was assessed using an external pressure transducer, and the CO insufflation volume was measured using an endoscopic CO-supplied device and flow meter. The following variables were examined: gastric pressure at baseline and gastric pressure, the CO insufflation volume, and compliance of the stomach when patients initially felt abdominal tension following CO insufflation.
No significant differences were observed in baseline gastric pressure or compliance of the stomach between the groups. Drug-resistant functional dyspepsia patients had a significantly smaller CO insufflation volume and lower gastric pressure when symptoms developed than nonfunctional dyspepsia patients. Based on a cutoff value of 1.25 L by receiver operating characteristic curves, sensitivity and specificity for gastric pressure were 85.0 and 96.3%, respectively. Similarly, based on a cutoff value of 12.7 mmHg, sensitivity and specificity for the CO insufflation volume were 81.5 and 81.5%, respectively.
This endoscopic gastric hypersensitivity testing is a useful tool for evaluating the presence of gastric hypersensitivity.
尽管胃超敏是功能性消化不良患者消化不良症状的病因之一,但目前尚无常规的内镜胃超敏检测方法。我们开发了一种新的内镜胃超敏检测方法。本研究的目的是调查该方法是否有助于评估高度怀疑存在胃超敏的难治性功能性消化不良患者的胃超敏情况。
招募了27例难治性功能性消化不良患者和27例非功能性消化不良患者。使用外部压力传感器评估胃内压,使用内镜CO供应装置和流量计测量CO注入量。检查以下变量:基线时的胃内压、患者在CO注入后最初感到腹部紧张时的胃内压、CO注入量以及胃的顺应性。
两组之间在基线胃内压或胃顺应性方面未观察到显著差异。难治性功能性消化不良患者在症状出现时的CO注入量显著小于非功能性消化不良患者,胃内压也更低。根据受试者工作特征曲线得出的1.25 L的临界值,胃内压的敏感性和特异性分别为85.0%和96.3%。同样,根据12.7 mmHg的临界值,CO注入量的敏感性和特异性分别为81.5%和81.5%。
这种内镜胃超敏检测是评估胃超敏存在情况的一种有用工具。