Ko C W, Chang C S, Lien H C, Wu M J, Chen G H
Dept. of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
Scand J Gastroenterol. 1998 Oct;33(10):1047-51. doi: 10.1080/003655298750026732.
Dyspeptic symptoms are common in uremic patients receiving hemodialysis. Investigators have placed emphasis on the changes in histopathology and physiology of the gastrointestinal tract. But not much data about the gastric myoelectric activity are available. The aim of this study was to assess gastric myoelectric activity in uremic patients undergoing hemodialysis.
Fifty-eight subjects were enrolled. They were assigned to: group I, uremic patients undergoing hemodialysis with dyspeptic complaints (n = 20); group II, non-uremic patients with matched dyspeptic complaints (n = 20); and group III, healthy volunteers without dyspeptic complaints (n = 18). Gastric myoelectric activity was measured with abdominal surface electrodes in each person. Patients in group I were measured twice, before (group Ia) and after (group Ib) hemodialysis. The data were compared between the groups.
In the prehemodialysis period there was a significantly lower percentage of normal slow-wave frequency when compared with group III (fasting, 66.54%+/-5.39% versus 84.58%+/-3.63%; P < 0.005; fed, 72.25%+/-4.16% versus 89.06%+/-2.57%; P < 0.01). In the post-hemodialysis period the difference was even more profound (fasting, 46.52%+/-4.26% versus 84.58%+/-3.63%; P < 0.001; fed, 51.49%+/-6.89% versus 89.06%+/-2.57%; P < 0.005). Yet, when compared with group II, a significant difference existed only in the post-hemodialysis period (fasting, 46.52%+/-4.26% versus 67.30%+/-3.46%; P<0.001; fed, 51.49%+/-6.89% versus 70.41%+/-4.39%; P < 0.01). Another finding is that hemodialysis decreased the gastric myoelectric activity after hemodialysis (fasting, 66.54%+/-5.39% versus 46.52%+/-4.26%; P < 0.001; fed, 72.25%+/-4.16% versus 51.49%+/-6.89%; P < 0.005).
Uremic patients undergoing hemodialysis have impaired gastric myoelectric activity. Interestingly, hemodialysis seems to cause deterioration in gastric myoelectric activity.
消化不良症状在接受血液透析的尿毒症患者中很常见。研究人员一直强调胃肠道组织病理学和生理学的变化。但关于胃肌电活动的数据并不多。本研究的目的是评估接受血液透析的尿毒症患者的胃肌电活动。
招募了58名受试者。他们被分为：第一组，有消化不良症状的接受血液透析的尿毒症患者（n = 20）；第二组，有匹配消化不良症状的非尿毒症患者（n = 20）；第三组，无消化不良症状的健康志愿者（n = 18）。用腹部表面电极测量每个人的胃肌电活动。第一组患者在血液透析前（第一a组）和血液透析后（第一b组）各测量一次。对各组数据进行比较。
与第三组相比，血液透析前正常慢波频率的百分比显著降低（空腹时，66.54%±5.39%对84.58%±3.63%；P < 0.005；进食后，72.25%±4.16%对89.06%±2.57%；P < 0.01）。血液透析后差异更为显著（空腹时，46.52%±4.26%对84.58%±3.63%；P < 0.001；进食后，51.49%±6.89%对89.06%±2.57%；P < 0.005）。然而，与第二组相比，仅在血液透析后存在显著差异（空腹时，46.52%±4.26%对67.30%±3.46%；P<0.001；进食后，51.49%±6.89%对70.41%±4.39%；P < 0.01）。另一个发现是血液透析使血液透析后的胃肌电活动降低（空腹时，66.54%±5.39%对46.52%±4.26%；P < 0.001；进食后，72.25%±4.16%对51.49%±6.89%；P < 0.005）。
接受血液透析的尿毒症患者胃肌电活动受损。有趣的是，血液透析似乎会导致胃肌电活动恶化。
