Mantides A, Stefanides G, Kioulanis J, Tzovaras G, Epanomeritakis E, Xynos E
Department of Gastroenterology, Athens Naval and Veterans Hospital, Greece.
Am J Gastroenterol. 1997 Jul;92(7):1190-3.
Gastric dysrhythmias have been noted in diabetic patients with upper GI symptoms attributed to delayed gastric emptying. The aim of this study was to assess gastric myoelectrical activity in patients with asymptomatic insulin-dependent diabetes mellitus.
Nine healthy subjects (five men, four women) and ten patients with insulin-dependent diabetes (six men, four women) participated in the study. Percutaneous electrogastrography was applied with a portable device on all subjects for 2 h before, during, and 2 h after the ingestion of a standard meal. Spectral analysis of the traces was performed on a personal computer using devoted software. The parameters assessed were 1) the percentile distribution of the three spectra of gastric slow-wave frequency, defined as follows: bradygastria for 0-2.4 cycles/min, normogastria for 2.5-3.6 cycles/min, and tachygastria for 3.7-9 cycles/min; and 2) the fed/fasting ratio of slow-wave power at all three spectra of frequencies.
Bradygastria was significantly more common during the entire period of recording (p = 0.024), and in particular during the fasting state (p = 0.0008) and the period of meal consumption (p = 0.0001) in diabetic patients than in controls. In addition, the presence of normogastria did not increase significantly after the meal in diabetic patients as it did in controls. In diabetic patients, the slow-wave power decreased postprandially at the spectra of bradygastria and normogastria, unlike the controls, who exhibited a respective postprandial increase (fed/fasting power, controls vs patients:p = 0.0006 for bradygastria, p < 0.0001 for normogastria).
Gastric dysrhythmias are present even in diabetic patients without upper GI symptoms attributed to gastric stasis. Increased presence of bradygastria and failure to increase the slow-wave amplitude postprandially are the predominant forms of abnormal myoelectrical activity in these cases.
在患有归因于胃排空延迟的上消化道症状的糖尿病患者中已观察到胃节律紊乱。本研究的目的是评估无症状胰岛素依赖型糖尿病患者的胃肌电活动。
9名健康受试者（5名男性，4名女性）和10名胰岛素依赖型糖尿病患者（6名男性，4名女性）参与了该研究。在所有受试者摄入标准餐之前、期间和之后2小时，使用便携式设备进行经皮胃电图检查。使用专门软件在个人计算机上对记录进行频谱分析。评估的参数为：1）胃慢波频率的三个频谱的百分位数分布，定义如下：每分钟0 - 2.4次循环为胃动过缓，每分钟2.5 - 3.6次循环为胃动正常，每分钟3.7 - 9次循环为胃动过速；2）所有三个频率频谱的慢波功率的进食/禁食比。
在整个记录期间，胃动过缓在糖尿病患者中显著更常见（p = 0.024），特别是在禁食状态（p = 0.0008）和进食期间（p = 0.0001），与对照组相比。此外，糖尿病患者进食后胃动正常的情况没有像对照组那样显著增加。与对照组不同，糖尿病患者餐后胃动过缓和胃动正常频谱的慢波功率下降，对照组餐后慢波功率各自增加（进食/禁食功率，对照组与患者相比：胃动过缓p = 0.0006，胃动正常p < 0.0001）。
即使在没有归因于胃潴留的上消化道症状的糖尿病患者中也存在胃节律紊乱。胃动过缓增加以及餐后慢波振幅未能增加是这些病例中异常肌电活动的主要形式。
