Varghese Chris, Schamberg Gabriel, Uren Emma, Calder Stefan, Law Mikaela, Foong Daphne, Ho Vincent, Wu Billy, Huang I-Hsuan, Du Peng, Abell Thomas, Daker Charlotte, Andrews Christopher N, Gharibans Armen A, O'Grady Gregory
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Alimetry Ltd, Auckland, New Zealand.
Gastro Hep Adv. 2024 Sep 7;4(1):100547. doi: 10.1016/j.gastha.2024.09.002. eCollection 2025.
Gastric Alimetry™ (Alimetry, New Zealand) is a new clinical test for gastroduodenal disorders involving simultaneous body surface gastric electrical mapping and validated symptom profiling. Studies have demonstrated a range of distinct pathophysiological profiles, and a classification scheme is now required. We used Gastric Alimetry spectral and symptom profiles to develop a mechanism-based test classification scheme, then assessed correlations with symptom severity, psychometrics, and quality of life.
We performed a multicenter prospective cohort study of patients meeting the Rome IV criteria for functional dyspepsia and chronic nausea and vomiting syndromes. Patients underwent Gastric Alimetry profiling, and a standardized digital classification framework was devised and applied to separate patients into those with a) abnormal spectral analyses (ie aberrant gastric frequencies, amplitudes, and rhythms); and normal spectral analyses with b) symptoms to gastric amplitude (subgroups: sensorimotor, postgastric, and activity-relieved), and c) symptoms of gastric amplitude (subgroups: continuous, meal-relieved, meal-induced).
Two hundred ten patients were included (80% female, median age 37), of whom 169 met the criteria for chronic nausea and vomiting syndromes and 206 met the criteria for functional dyspepsia (79% meeting both criteria). Overall, 83% were phenotyped using the novel scheme, with 79/210 (37.6%) classified as having a spectral abnormality. Of the remainder, the most common phenotypes were "continuous pattern" (37, 17.6%), "meal-induced pattern" (28, 13.3%), and "sensorimotor pattern" (15, 7.1%). Symptom patterns independent of gastric amplitude were more strongly correlated with depression and anxiety (Patient Health Questionnaire 2: exp(β) 2.38, = .024, State-Trait Anxiety Inventory Short-Form score: exp(β) 1.21, = .021).
A mechanistic classification scheme for assessing gastroduodenal disorders is presented. Classified phenotypes showed independent relationships with symptom severity, quality of life, and psychological measures. The scheme is now being applied clinically and in research studies.
胃电分析技术（Gastric Alimetry™，新西兰）是一种用于胃十二指肠疾病的新型临床检测方法，它能同时进行体表胃电测绘并验证症状特征。研究已证实存在一系列不同的病理生理特征，因此现在需要一个分类方案。我们利用胃电分析技术的频谱和症状特征制定了一个基于机制的检测分类方案，然后评估其与症状严重程度、心理测量指标和生活质量的相关性。
我们对符合罗马IV功能性消化不良及慢性恶心和呕吐综合征标准的患者进行了一项多中心前瞻性队列研究。患者接受胃电分析技术检测，并设计并应用了一个标准化的数字分类框架，将患者分为以下几类：a）频谱分析异常（即胃频率、振幅和节律异常）；频谱分析正常，但伴有b）与胃振幅相关的症状（亚组：感觉运动型、胃后型和活动缓解型），以及c）与胃振幅相关的症状（亚组：持续型、进餐缓解型、进餐诱发型）。
共纳入210例患者（80%为女性，中位年龄37岁），其中169例符合慢性恶心和呕吐综合征标准，206例符合功能性消化不良标准（79%同时符合两项标准）。总体而言，83%的患者通过新方案进行了表型分类，其中79/210（37.6%）被分类为频谱异常。其余患者中，最常见的表型为“持续型”（37例，17.6%）、“进餐诱发型”（28例，13.3%）和“感觉运动型”（15例，7.1%）。与胃振幅无关的症状模式与抑郁和焦虑的相关性更强（患者健康问卷2：exp(β) 2.38，P = 0.024；状态-特质焦虑量表简表得分：exp(β) 1.21，P = 0.021）。
提出了一种用于评估胃十二指肠疾病的基于机制的分类方案。分类后的表型与症状严重程度、生活质量和心理测量指标显示出独立的关系。该方案目前正在临床和研究中应用。
