Koch K L, Bingaman S, Tan L, Stern R M
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Neurogastroenterol Motil. 1998 Feb;10(1):3-10. doi: 10.1046/j.1365-2982.1998.00080.x.
Bulimia nervosa remains a common eating disorder in young women. Little is known about upper gastrointestinal symptoms or gastric motility in patients with bulimia nervosa. The aim of this study was to measure gastric myoelectrical activity and hunger/satiety and stomach emptiness/fullness before and after a non-nutrient water load and solid-phase gastric emptying in hospitalized patients with bulimia nervosa (n = 12) and in healthy women (n = 13). Gastric myoelectrical activity was measured by means of cutaneous electrodes; visual analogue scales were used to measure perceptions of hunger/satiety and stomach emptiness/fullness. Before and after a standard water load the bulimia patients reported significantly greater stomach fullness and satiety compared with control subjects (P < 0.01). The percentage of gastric myoelectrical power in the normal 3 cpm range was significantly less in bulimics compared with controls. Power in the 1-2 cpm bradygastria range was significantly greater in bulimia patients before and after the water load compared with the control subjects (P < 0.05). Solid-phase gastric emptying studies using radio-isotope-labelled scrambled eggs showed the lag phase was shortened in the bulimic patients (16 +/- 4 min vs 31 +/- 4 min in controls, P < 0.01), but the percentage of meal emptied at 2 h was similar to control values.
bulimia patients had exaggerated perceptions of stomach fullness and satiety in response to water; and abnormal gastric myoelectrical activity and accelerated lag phase of gastric emptying were objective stomach abnormalities detected in hospitalized patients with bulimia nervosa.
神经性贪食症仍是年轻女性中常见的饮食失调症。对于神经性贪食症患者的上消化道症状或胃动力了解甚少。本研究的目的是测量神经性贪食症住院患者(n = 12)和健康女性(n = 13)在非营养性水负荷前后的胃肌电活动、饥饿/饱腹感以及胃排空/充盈情况,以及固相胃排空情况。胃肌电活动通过皮肤电极进行测量;视觉模拟量表用于测量饥饿/饱腹感以及胃排空/充盈的感知。在标准水负荷前后,与对照组相比,神经性贪食症患者报告的胃部饱腹感和饱腹感明显更强(P < 0.01)。与对照组相比,神经性贪食症患者正常3次/分钟范围内的胃肌电功率百分比明显更低。在水负荷前后,神经性贪食症患者1 - 2次/分钟的胃缓慢性范围的功率与对照组相比明显更高(P < 0.05)。使用放射性同位素标记的炒鸡蛋进行的固相胃排空研究表明,神经性贪食症患者的延迟期缩短(16 ± 4分钟,对照组为31 ± 4分钟,P < 0.01),但2小时时排空的食物百分比与对照值相似。
神经性贪食症患者对水的反应表现为胃部饱腹感和饱腹感的夸大;胃肌电活动异常以及胃排空延迟期加速是在神经性贪食症住院患者中检测到的客观胃部异常情况。