Holtmann G, Goebell H, Talley J
Division of Gastroenterology, University of Essen. Germany.
Am J Gastroenterol. 1996 Mar;91(3):485-91.
To study disturbances of gastrointestinal motility and afferent (sensory) dysfunction in functional (unexplained) dyspepsia, and the interrelationships between motility and sensory dysfunction.
Twelve patients with functional dyspepsia and 12 controls matched for age and gender were studied. Intestinal perception thresholds were tested by a standardized stepwise distension procedure in the third portion of the duodenum with a barostat device. Small intestinal motility was measured with a low compliance perfusion system proximal and distal to the distending balloon.
First perception of duodenal balloon distension occurred at significantly (p <0.01) lower pressures in patients (23 +/- 3 mm Hg, mean +/- SEM) than in healthy controls (31 +/- 3 mm Hg). Patients had a lower maximal intestinal pain tolerance than controls (31 +/- 2 mm Hg vs. 39 +/- 1 mm Hg, p <0.05). Duodenal distension inhibited intestinal motility distal to the distending balloon (peristaltic reflex) more often in health controls (11/12) than in patients with functional dyspepsia (5/12, p <0.05). These alterations of small intestinal motility occurred at pressure values below the perception thresholds, and disturbed motility responses were not associated with perception thresholds.
Disturbed peristaltic reflexes and decreased sensory thresholds for perception of intestinal sensations are prevalent but may be independent abnormalities in patients with unexplained dyspepsia.
研究功能性（不明原因）消化不良患者的胃肠动力紊乱及传入（感觉）功能障碍，以及动力与感觉功能障碍之间的相互关系。
对12例功能性消化不良患者和12例年龄及性别匹配的对照者进行研究。使用恒压器装置，通过标准化的逐步扩张程序在十二指肠第三段测试肠道感觉阈值。使用低顺应性灌注系统在扩张球囊近端和远端测量小肠动力。
十二指肠球囊扩张的首次感觉在患者中出现时的压力（23±3mmHg，平均值±标准误）显著低于健康对照者（31±3mmHg，p<0.01）。患者的最大肠道疼痛耐受度低于对照者（31±2mmHg对39±1mmHg，p<0.05）。十二指肠扩张对扩张球囊远端肠道动力的抑制作用（蠕动反射）在健康对照者中（11/12）比在功能性消化不良患者中（5/12，p<0.05）更常见。这些小肠动力改变发生在低于感觉阈值的压力值时，且动力反应紊乱与感觉阈值无关。
在不明原因消化不良患者中，蠕动反射紊乱和肠道感觉的感觉阈值降低很常见，但可能是独立的异常情况。
