谷成明 柯美云 张淑琴 姜玉新 刘燕萍 100730 中国医学科学院、中国协和医科大学北京协和医院消化科 中华内科杂志 1998 0 37 8


    关键词：消化不良；胃肠活动 期刊 zhnkzz 0 论 著 fur -->


    

【摘要】 目的 探讨胃窦幽门十二指肠运动功能在功能性消化不良(FD)发病中的作用。方法 采用彩色多普勒超声技术对胃的蠕动周期、排空周期、胃窦幽门十二指肠协调收缩及幽门功能进行了研究。结果 14名正常人餐后胃收缩频率平均为3.15±0.02次/分，21例FD病人为3.18±0.02次/分(P值>0.05)。正常人及FD病人餐后各时间段平均胃排空时间无明显差异。正常组>10秒的胃排空周期百分率为53.3%，FD组为32.4%(P值<0.01)。餐后胃窦幽门十二指肠协调收缩百分率为71.0%，FD组为58.3%(P值<0.001)。21例病人中有5例表现有幽门关闭不全，占23.8%。14例正常人中无一例出现幽门关闭不全。结论 幽门功能的损害和胃窦幽门十二指肠协调收缩障碍可能是功能性消化不良发病的重要机制。

    Antropyloroduodenal dyscoordination infunctional dyspepsia studied by color Doppler flow imaging Gu Chengming, Ke Meiyun, Zhang Shuqin, et al. Department of Gastroenterology, Chinese Academy of Medical Science, Peking UnionMedical College Hospital, Beijing 100730

    【Abstract】 Objective Theaim of the study was to investigate the physiology and pathophysiologyof gastric liquid emptying in healthy subject (HS) and in patientswith functional dyspepsia (FD).Methods FourteenHS and 21 FD were studied by color Doppler flow imaging (HP 8500 GP).After an overnight fast, all HS and patients were placed in a sittingposition. Totally 300 ml liquid meal (P:C:F=1:1:7, 1.26×10³ kJ) was consumed. The ultrasonographic probe was positioned attranspyloric plane to visualize the movement of gastric wall, theopening and closure of pylorus and transpyloric movement ofintragastric contents for 120 minutes postprandially except for ashort break at 70～90 minutes.Results (1) No significantdifference was observed between the contractile frequency in HS (3.15±0.02 cpm) and in FD (3.18±0.02 cpm). The cycle lengths of gastriccontraction were 19.20±0.37, 19.03±0.29 and 18.98±0.64 sec. in HSand 18.97±0.30, 18.68±0.26 and 18.88±0.58 sec. in FD during thefirst, second, and forth half hour. A vary stable pattern was observedin both normal and dyspeptic group (P>0.05). (2) The averageemptying time during the first, second and forth half hour were 8.63±1.72,9.68±4.16 and 8.48±1.85 sec. in HS and 7.88±1.17, 8.12±2.22 and7.70±1.64 sec. in FD respectively. No significant difference wasfound between these two groups (P>0.05). The percentage of emptyingtime >10 sec. decreased significantly in FD (32.4%) compared withHS (53.3%, P<0.01). (3) The percentage of antropyloroduodenalcontraction decreased significantly in FD (58.3%) compared with HS(71.0%, P<0.001). (4)Pyloric incompetence was found in 5 out of 21patients (23.8%), but not in any healthy subject. A continuousinterchange of anterograde and retrograde transpyloric flows could beobserved in all these 5 patients by both color and Doppler sonography.Conclusion (1) Gastriccontractile frequency during postprandial stage keeps a very stablepattern in either HS and FD group. (2)The coordination ofantropyloroduodenum may play a key role in gastric emptying ofliquids. (3) Pyloric incompetence impairs the coordination ofantropyloroduodenal motility and the shivering capacity of pylorus.The dysfunction of pylorus and dyscoordination of antropyloroduodenalmotility may be important factors for delayed gastric emptying andpathogenesis of functional dyspepsia.

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