Ko C W, Chang C S, Wu M J, Chen G H
Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
Dig Dis Sci. 1998 Jun;43(6):1159-64. doi: 10.1023/a:1018878901727.
Upper gastrointestinal discomforts are common in uremic patients. Investigators have stressed the structural, histopathological, and physiological changes in the gastrointestinal tract in the past decades. Few data are available about the electrophysiological changes in the stomach of uremic patients. It is not known whether hemodialysis alters gastric myoelectrical activity. More interestingly, what is the long-term effect? To address these questions, we measured gastric myoelectrical activity before and after hemodialysis in patients with end-stage renal disease on maintenance dialysis treatment. Twenty-one uremic patients with dyspeptic complaints were enrolled in this study. Gastric myoelectrical activity was measured noninvasively using abdominal surface electrodes (electrogastrography). The paired variables obtained before and after hemodialysis were compared statistically. We also compared the difference between two subgroups defined as new hemodialysis patients and chronic hemodialysis patients. We found that there was a significantly lower percentage of normal slow-wave frequency obtained after hemodialysis in comparison with before hemodialysis (fasting state: 49.1 +/- 4.8% vs 68.1 +/- 5.4%, P < 0.01; fed state: 53.8 +/- 6.9% vs 73.4 +/- 4.1%, P < 0.01). In comparing the subgroups, there were no differences between each EGG variable. We concluded that the hemodialysis itself compromised gastric myoelectrical activity in its immediate effect. However, there were no permanent effects regarding gastric myoelectrical activity itself.
上消化道不适在尿毒症患者中很常见。在过去几十年里，研究人员一直强调胃肠道的结构、组织病理学和生理学变化。关于尿毒症患者胃部电生理变化的数据很少。目前尚不清楚血液透析是否会改变胃肌电活动。更有趣的是，长期影响是什么？为了解决这些问题，我们对接受维持性透析治疗的终末期肾病患者在血液透析前后测量了胃肌电活动。本研究纳入了21例有消化不良症状的尿毒症患者。使用腹部表面电极（胃电图）无创测量胃肌电活动。对血液透析前后获得的配对变量进行统计学比较。我们还比较了新血液透析患者和慢性血液透析患者这两个亚组之间的差异。我们发现，与血液透析前相比，血液透析后正常慢波频率的百分比显著降低（禁食状态：49.1±4.8%对68.1±5.4%，P<0.01；进食状态：53.8±6.9%对73.4±4.1%，P<0.01）。在比较亚组时，每个胃电图变量之间没有差异。我们得出结论，血液透析本身在其即时效应中损害了胃肌电活动。然而，对于胃肌电活动本身没有永久性影响。
