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慢性肾衰竭患者的胃排空延迟

Delayed gastric emptying in patients with chronic renal failure.

作者信息

Kao C H, Hsu Y H, Wang S J

机构信息

Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.

出版信息

Nucl Med Commun. 1996 Feb;17(2):164-7. doi: 10.1097/00006231-199602000-00012.

DOI:10.1097/00006231-199602000-00012
PMID:8778642
Abstract

Forty patients with chronic renal failure (CRF) were enrolled into the study, none of whom had peptic ulcer disease, amyloidosis, a previous abdominal operation, diabetes mellitus or other factors that could influence gastric emptying. Twenty of the 40 patients had been receiving regular haemodialysis (HD) for at least 1 year prior to the study. Twelve of the 40 patients had upper gastrointestinal symptoms/signs (GI Sx). Radionuclide-labelled solid meals were used to calculate gastric emptying time (GET). Twenty-five normal volunteers comprised the control group. Of the 40 patients, 35 (88%) had an abnormal GET. The incidence of an abnormal GET in HD and non-HD patients was 95 and 80%, respectively; the incidence of an abnormal GET in patients with and without upper GI Sx was 83 and 89%, respectively. These differences in the incidence of an abnormal GET among the HD and non-HD patients, as well as in the patients with and without upper GI Sx, were not statistically significant. There were no significant differences between the normal and abnormal GET patients for any of the following clinical parameters and conditions: dialyser-specific proportionality constant x time/urea distribution volume (KT/V), protein catabolic rate (PCR), ferritin, serum blood urea nitrogen, creatinine, calcium ion, phosphate, intact parathyroid hormone, albumin, uric acid, haemoglobin, triglyceride and cholesterol, total dialysis time, creatinine clearance and daily urine protein. We conclude that in Chinese patients with CRF, both dialysed and undialysed, an abnormal GET is common. The pathogenesis seems to be multifactorial. The presence of abdominal symptoms cannot foretell an abnormal GET.

摘要

40例慢性肾衰竭(CRF)患者被纳入本研究,他们均无消化性溃疡病、淀粉样变性、既往腹部手术史、糖尿病或其他可能影响胃排空的因素。40例患者中有20例在研究前已接受规律血液透析(HD)至少1年。40例患者中有12例有上消化道症状/体征(GI Sx)。使用放射性核素标记的固体餐来计算胃排空时间(GET)。25名正常志愿者组成对照组。40例患者中,35例(88%)GET异常。HD患者和非HD患者GET异常的发生率分别为95%和80%;有和无上消化道症状的患者GET异常的发生率分别为83%和89%。HD患者与非HD患者之间以及有和无上消化道症状患者之间GET异常发生率的这些差异无统计学意义。在以下任何临床参数和情况方面,GET正常和异常的患者之间均无显著差异:透析器特定比例常数×时间/尿素分布容积(KT/V)、蛋白质分解代谢率(PCR)、铁蛋白、血清血尿素氮、肌酐、钙离子、磷酸盐、完整甲状旁腺激素、白蛋白、尿酸、血红蛋白、甘油三酯和胆固醇、总透析时间、肌酐清除率和每日尿蛋白。我们得出结论,在中国CRF患者中,无论是否接受透析,GET异常都很常见。发病机制似乎是多因素的。腹部症状的存在不能预示GET异常。

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