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糖尿病患者的胃窦肌电活动、胃排空及消化不良症状

Antral myoelectric activity, gastric emptying, and dyspeptic symptoms in diabetics.

作者信息

Pfaffenbach B, Wegener M, Adamek R J, Schaffstein J, Lee Y H, Ricken D

机构信息

Dept. of Medicine, Ruhr University, Bochum, Germany.

出版信息

Scand J Gastroenterol. 1995 Dec;30(12):1166-71. doi: 10.3109/00365529509101626.

Abstract

BACKGROUND

Electrogastrography (EGG) enables the cutaneous measurement of gastric electric activity. An association between electric abnormalities and gastrointestinal motility disorders has been shown. The primary objective of this study was to investigate whether diabetic gastroparesis could be predicted by EGG.

METHODS

EGG was performed in 18 insulin-treated type-II diabetics (9 female, 9 male; median age, 64 years; range, 45-76 years) with chronic dyspepsia. After an overnight fast, during 1 h in the fasting and 1 h in the fed state after ingestion of a liquid-solid test meal (370 kcal; liquid phase labeled with 0.5 mCi 99mTc-colloid) antral electric activity was captured by one pair of electrodes sonographically placed on the skin overlying the gastric antrum. Several EGG variables including dominant frequency (DF), percentages of DF in the normal range (2-4 cycles per minute (cpm)), bradygastria (< 2 cpm), and tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to preprandial power ratio (PR) were calculated by fast Fourier transform. The data were correlated to results obtained in 20 age- and gender-matched healthy subjects (10 female, 10 male; median age, 68 years; range, 53-90 years). In addition, the data were compared with the percentages of retention of the radionuclide in the stomach at 60 min, and lag times measured by simultaneous scintigraphy.

RESULTS

The EGG values obtained in diabetics did not differ significantly from those in healthy subjects and did not correlate with radioscintigraphy (p > 0.05). Moreover, the EGG values in diabetics with delayed gastric emptying (about 40%) did not differ from data in diabetics without gastroparesis. Furthermore, whereas dyspepsia correlated significantly with radioscintigraphy, no correlation with EGG could be found.

CONCLUSIONS

Electrogastrography seems to be unsuitable for assessment of motility disorders in type-II diabetics.

摘要

背景

胃电图(EGG)可实现对胃电活动的体表测量。已证实电异常与胃肠动力障碍之间存在关联。本研究的主要目的是调查EGG能否预测糖尿病胃轻瘫。

方法

对18名患有慢性消化不良的接受胰岛素治疗的II型糖尿病患者(9名女性,9名男性;中位年龄64岁;范围45 - 76岁)进行EGG检查。禁食过夜后,在空腹1小时以及摄入液 - 固试验餐(370千卡;液相用0.5毫居里99mTc - 胶体标记)后进食状态下1小时,通过一对超声放置在胃窦上方皮肤的电极采集胃窦电活动。通过快速傅里叶变换计算多个EGG变量,包括主频(DF)、正常范围内DF的百分比(每分钟2 - 4个周期(cpm))、胃动过缓(<2 cpm)和胃动过速(4 - 10 cpm)、主频不稳定系数(DFIC)以及餐后与餐前功率比(PR)。将这些数据与20名年龄和性别匹配的健康受试者(10名女性,10名男性;中位年龄68岁;范围53 - 90岁)的结果进行关联。此外,将数据与60分钟时胃内放射性核素滞留百分比以及同时进行的闪烁扫描测量的延迟时间进行比较。

结果

糖尿病患者获得的EGG值与健康受试者的EGG值无显著差异,且与放射性核素显像无相关性(p>0.05)。此外,胃排空延迟的糖尿病患者(约40%)的EGG值与无胃轻瘫的糖尿病患者的数据无差异。而且,虽然消化不良与放射性核素显像显著相关,但未发现与EGG有相关性。

结论

胃电图似乎不适用于评估II型糖尿病患者的动力障碍。

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