Takayasu H, Harasawa S, Miwa T, Yamada Y
Department of 6th Internal Medicine, School of Medicine, Tokai University.
Nihon Shokakibyo Gakkai Zasshi. 1993 Apr;90(4):743-54.
One hundred and fourty four patients with non-ulcer dyspepsia (NUD), as defined by the working party of AGA in 1987, (67 men and 77 women, 16-76 years, mean age 42.9 +/- 1.2 years) and 34 asymptomatic controls (25 men and 9 women, 17-75 years, mean age 50.6 +/- 2.4 years) parameters of gastrophysiological function (gastric acid secretion, postprandial gastric emptying-acetaminophen method, serum gastrin levels and cutaneous electrogastrography (EGG)) and the prevalence of Helicobacter pylori (Hp) (histological and urease test of biopsy specimens) were investigated. Based on symptom patterns, there were 68 patients with dysmotility-like dyspepsia, 27 with ulcer-like dyspepsia, 17 with reflux-like dyspepsia, 6 with aerophagia and the 26 with nonspecific or idiopathic dyspepsia. The age distribution of NUD was predominant in the fourth decade, and the sex distribution was not significantly different. In general, hypersecretion of gastric acid and hypergastrinemia were rare in NUD patients. There was no significant difference in gastric acid secretion, basal and food stimulated serum gastrin levels and prevalence of Hp between the two groups. But 51 of 144 NUD patients (41.1%) had delayed gastric emptying (p < 0.05) compared to controls. Indeed gastric emptying was markedly prolonged in patients with dysmotility-like (58.1%) and reflux-like (42.9%) dyspepsia. On EGG, about a half of NUD patients showed evidence of bradygastria or tachygastria, in particular in the postprandial state, which was related to delayed gastric emptying. By chronic administration of cisapride, score of symptoms was significantly decreased and postprandial gastric emptying was significantly accelerated in delayed gastric emptying cases. We conclude that in NUD patients, in particular those with dysmotility-like dyspepsia, tests of postprandial gastric emptying and/or EGG are useful for investigation of gastric motor disorder and therapeutic effects of several prokinetic drugs clinically.
对144例符合美国胃肠病学会（AGA）1987年工作组定义的非溃疡性消化不良（NUD）患者（67例男性和77例女性，年龄16 - 76岁，平均年龄42.9±1.2岁）以及34例无症状对照者（25例男性和9例女性，年龄17 - 75岁，平均年龄50.6±2.4岁）的胃生理功能参数（胃酸分泌、餐后胃排空 - 对乙酰氨基酚法、血清胃泌素水平和皮肤胃电图（EGG））以及幽门螺杆菌（Hp）的感染率（活检标本的组织学和尿素酶试验）进行了研究。根据症状类型，有68例运动障碍样消化不良患者、27例溃疡样消化不良患者、17例反流样消化不良患者、6例吞气症患者以及26例非特异性或特发性消化不良患者。NUD患者的年龄分布以第四年龄段为主，性别分布无显著差异。总体而言，NUD患者中胃酸分泌过多和高胃泌素血症较为罕见。两组在胃酸分泌、基础和食物刺激后的血清胃泌素水平以及Hp感染率方面无显著差异。但与对照组相比，144例NUD患者中有51例（41.1%）胃排空延迟（p < 0.05）。实际上，运动障碍样（58.1%）和反流样（42.9%）消化不良患者的胃排空明显延长。在EGG检查中，约一半的NUD患者显示有胃动过缓或胃动过速的迹象，尤其是在餐后状态，这与胃排空延迟有关。通过长期服用西沙必利，胃排空延迟病例的症状评分显著降低，餐后胃排空明显加快。我们得出结论，在NUD患者中，尤其是那些有运动障碍样消化不良的患者，餐后胃排空试验和/或EGG检查对于临床研究胃动力障碍和几种促动力药物的治疗效果是有用的。
