Samsom M, Salet G A, Roelofs J M, Akkermans L M, Vanberge-Henegouwen G P, Smout A J
Department of Gastroenterology, University Hospital Itrecht, The Netherlands.
Dig Dis Sci. 1995 Sep;40(9):2037-42. doi: 10.1007/BF02208676.
In the present study the function of the proximal stomach and its role in eliciting dyspeptic symptoms were evaluated in patients with diabetes mellitus. Eight type I diabetics with cardiovascular autonomic neuropathy and dyspeptic symptoms, and 10 healthy volunteers were studied using an electronic barostat device connected to a intragastric bag. The intragastric bag was inflated and deflated by stepwise pressure increments, creating pressure-volume curves. During the experiment the blood glucose concentrations were maintained within the euglycemic range in the diabetics. The volume-pressure curves showed a larger volume during the pressure increase in the diabetics than in the controls (P < 0.01). This resulted in a significant difference in compliance (dV/dP), 57.2 +/- 4.2 ml/mm Hg in diabetics and 43.7 +/- 3.5 ml/MM Hg in controls (P < 0.014). The volume-pressure curves during deflation of the intragastric balloon were different from the curves during inflation, creating a hysteresis loop. The area between the inflation and deflation curves was 827 ml/mm Hg in diabetics and 627 ml/mm Hg in the controls (P = 0.21). Gastric distension induced more upper gastrointestinal sensations in the patients than in the volunteers: nausea (P < 0.002), bloating (P < 0.003), upper abdominal pain (P < 0.001).
this study showed that the compliance of the proximal stomach is increased in diabetic patients with autonomic neuropathy and gastrointestinal symptoms. This abnormality, probably due to autonomic neuropathy, is associated with increased symptom generation during gastric distension.
在本研究中，对糖尿病患者近端胃的功能及其在引发消化不良症状中的作用进行了评估。使用连接到胃内气囊的电子恒压器装置，对8名患有心血管自主神经病变和消化不良症状的I型糖尿病患者以及10名健康志愿者进行了研究。通过逐步增加压力使胃内气囊充气和放气，绘制压力-容积曲线。在实验过程中，糖尿病患者的血糖浓度维持在正常血糖范围内。压力增加时，糖尿病患者的压力-容积曲线显示出比对照组更大的容积（P < 0.01）。这导致顺应性（dV/dP）存在显著差异，糖尿病患者为57.2±4.2 ml/mm Hg，对照组为43.7±3.5 ml/MM Hg（P < 0.014）。胃内气囊放气期间的压力-容积曲线与充气期间的曲线不同，形成了滞后环。糖尿病患者充气和放气曲线之间的面积为827 ml/mm Hg，对照组为627 ml/mm Hg（P = 0.21）。与志愿者相比，胃扩张在患者中诱发了更多的上消化道感觉：恶心（P < 0.002）、腹胀（P < 0.003）、上腹部疼痛（P < 0.001）。
本研究表明，患有自主神经病变和胃肠道症状的糖尿病患者近端胃的顺应性增加。这种异常可能归因于自主神经病变，与胃扩张期间症状产生增加有关。
