Bityutskiy L P, Soykan I, McCallum R W
Division of Gastroenterology, Hepatology & Nutrition, University of Virginia Health Sciences Center, Charlottesville, USA.
Am J Gastroenterol. 1997 Sep;92(9):1501-4.
Viral gastroparesis has been regarded as a subgroup of idiopathic gastroparesis.
We have reviewed the medical records of 143 patients diagnosed as having gastroparesis. Fifty-two patients were regarded as idiopathic in origin, of which 12 were identified as consistent with a postviral etiology. Their follow-up and current status were assessed by interview. Available for interview were 32 patients: 11 from the viral group and 21 from idiopathic group.
All "viral gastroparesis" patients reported gradual improvement of their symptoms, no hospitalizations during the previous 6 months, stable weight, were not disabled, and remained professionally active. In comparison, 21 "idiopathic" patients had an indolent, slowly progressive clinical presentation. The idiopathic group had a significantly longer duration of illness (p < 0.05) with greater symptom score of abdominal pain, early satiety, and anorexia, and overall worse quality of life (p < 0.05).
A viral etiology should be considered in gastroparesis patients when their illness is characterized by an acute onset, initial severe illness and slow resolution toward a satisfactory quality of life. Idiopathic gastroparesis is a more slowly progressive illness, and patients remain significantly more symptomatic for a longer period of time.
病毒性胃轻瘫被视为特发性胃轻瘫的一个亚组。
我们回顾了143例被诊断为胃轻瘫患者的病历。52例患者病因不明，其中12例被确定符合病毒感染后的病因。通过访谈评估他们的随访情况和当前状态。可供访谈的有32例患者：病毒组11例，特发性组21例。
所有“病毒性胃轻瘫”患者均报告症状逐渐改善，前6个月未住院，体重稳定，无残疾，仍积极工作。相比之下，21例“特发性”患者临床表现为病情进展缓慢、病程迁延。特发性组的病程明显更长（p<0.05），腹痛、早饱、厌食等症状评分更高，总体生活质量更差（p<0.05）。
胃轻瘫患者若起病急、初期病情严重且向满意生活质量缓慢恢复，应考虑病毒病因。特发性胃轻瘫是一种进展更缓慢的疾病，患者在更长时间内症状明显更严重。
