胃钡奶造影检查在功能性消化不良诊断中的价值
摘要
目的:探讨胃钡奶造影检查在功能性消化不良(FD)诊断中的价值及FD患者胃排空功能与临床症状的关系。
方法:30例FD患者、22例健康志愿者,12例FD治疗前后自身对照,口服硫酸钡和牛奶配制成100%的钡奶液150ml,分别在餐后0分钟、30分钟、60分钟、90分钟摄片,观察消化期不同时相胃中间横带宽度,近端胃钡剂残留率,远端胃钡剂残留率,近端胃和远端胃面积,胃排空率,临床症状积分,胃中间横带宽度、胃面积、胃排空率、临床症状的相关性。
结果:FD组的胃中间横带宽度均较健康组增宽,餐后30分钟、60分钟、90分钟两组比较有显著性差异(P＜0.05),餐后60分钟近端胃钡剂残留率FD组较健康组大,FD组30分钟、60分钟、90分钟远端胃钡剂残留率较健康组明显增大,以60分钟、90分钟明显(P＜0.01),FD治疗后90分钟远端胃钡剂残留率较治疗前变小;胃排空与远端胃面积关系密切(P＜0.01);FD治疗后症状总积分改善(P＜0.01)。
结论:FD症状与胃排空功能失调有关,胃钡奶造影检查在FD诊断中有较大价值,可以作为一种评价FD患者胃排空功能的简便的检查方法。
Objective:To assess the value of barium sulfate-milk mixed liquor in diagnosing functional dyspepsia(FD) and the relationship of patients with functional dyspepsia(FD) between gastric emptying function and clinic symptom.
Methods:This study included 30 cases of functional dyspepsia(FD),22 eases of volunteers and 12 cases of functional dyspepsia(FD) of own control before and after treatment.Take photographs respectively 0 minute,30 minutes,60 minutes and 90 minutes after taking orally 100%barium sulfate-milk mixed liquor to observe the midgastric-transverse band(MTB),barium residual rate in proximal and distal gastral cavity during different phases.
Results:As for MTB,FD group was significantly wider than volunteer group(30, 60 and 90 minutes after taking orally sulfate-milk mixed liquor respectively,p＜0.005). As for barium residual rate in proximal gastral cavity 60 minutes after taking orally sulfate-milk mixed liquor,FD group was higher than volunteer group.As for barium residual rate in distal gastral cavity 60 minutes and 90 minutes after taking orally sulfate-milk mixed liquor,FD group was significantly higher than volunteer group (p＜0.001).As for barium residual rate in distal gastral cavity 90 minutes,group post-treatment was lower than group pretherapy.The patients with FD make better their clinic symptom after treatment(P＜0.01).
Conclusions:The symptoms of FD relate to maladjustment of gastric function. Barium sulfate-milk mixed liquor is useful in diagnosing FD and can be used for a convenient assessment approach.
方法:30例FD患者、22例健康志愿者,12例FD治疗前后自身对照,口服硫酸钡和牛奶配制成100%的钡奶液150ml,分别在餐后0分钟、30分钟、60分钟、90分钟摄片,观察消化期不同时相胃中间横带宽度,近端胃钡剂残留率,远端胃钡剂残留率,近端胃和远端胃面积,胃排空率,临床症状积分,胃中间横带宽度、胃面积、胃排空率、临床症状的相关性。
结果:FD组的胃中间横带宽度均较健康组增宽,餐后30分钟、60分钟、90分钟两组比较有显著性差异(P＜0.05),餐后60分钟近端胃钡剂残留率FD组较健康组大,FD组30分钟、60分钟、90分钟远端胃钡剂残留率较健康组明显增大,以60分钟、90分钟明显(P＜0.01),FD治疗后90分钟远端胃钡剂残留率较治疗前变小;胃排空与远端胃面积关系密切(P＜0.01);FD治疗后症状总积分改善(P＜0.01)。
结论:FD症状与胃排空功能失调有关,胃钡奶造影检查在FD诊断中有较大价值,可以作为一种评价FD患者胃排空功能的简便的检查方法。
Objective:To assess the value of barium sulfate-milk mixed liquor in diagnosing functional dyspepsia(FD) and the relationship of patients with functional dyspepsia(FD) between gastric emptying function and clinic symptom.
Methods:This study included 30 cases of functional dyspepsia(FD),22 eases of volunteers and 12 cases of functional dyspepsia(FD) of own control before and after treatment.Take photographs respectively 0 minute,30 minutes,60 minutes and 90 minutes after taking orally 100%barium sulfate-milk mixed liquor to observe the midgastric-transverse band(MTB),barium residual rate in proximal and distal gastral cavity during different phases.
Results:As for MTB,FD group was significantly wider than volunteer group(30, 60 and 90 minutes after taking orally sulfate-milk mixed liquor respectively,p＜0.005). As for barium residual rate in proximal gastral cavity 60 minutes after taking orally sulfate-milk mixed liquor,FD group was higher than volunteer group.As for barium residual rate in distal gastral cavity 60 minutes and 90 minutes after taking orally sulfate-milk mixed liquor,FD group was significantly higher than volunteer group (p＜0.001).As for barium residual rate in distal gastral cavity 90 minutes,group post-treatment was lower than group pretherapy.The patients with FD make better their clinic symptom after treatment(P＜0.01).
Conclusions:The symptoms of FD relate to maladjustment of gastric function. Barium sulfate-milk mixed liquor is useful in diagnosing FD and can be used for a convenient assessment approach.
引文
[1]邹多武,许国铭.功能性消化不良.中华消化杂志,2006,26(11):765-767.
[2]江鸿志.重视对功能性消化不良的研究.中华内科杂志,1998,37(8):509.
[3]Sarnelli G,Caenepeel P,Geypens B,Janssens J,Tack J.Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.Am J Gastroenterol,2003,98:783-788.
[4]Tack J,Piessevaux H,Coulie B,Caenepeel P,Janssens J.Role of impaired gastric accommodation to a meal in functional dyspepsia.Gastroenterology,1998,115:1346-1352.
[5]左国文,覃江,农兵,等.功能性消化不良胃电活动的临床观察.临床荟萃,2004,19:1150-1151.
[6]陈波,张建忠,万小平,等.功能性消化不良患者胃十二指肠运动功能的研究[J].胃肠病学和肝病学杂志,2000,9(4):267-269.
[7]朱良如,谢小平,侯晓华.功能性消化不良患者胃机械感觉过敏.胃肠病学,2006,11:30-33.
[8]孙燕,侯晓华.内脏感觉过敏与功能性胃肠病.临床内科杂志,2005,22(5):359-360.
[9]Akkermans LM,van Isselt JW.Gastric motility and emptying studies with radionuclides in research and clinical settings.Dig Dis Sci,1994,39:95S-96S.
[10]Tougas G,Chen Y,Coates G,et al.Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting.Am J Gastroenterol,2000,95:78-86.
[11]郑敏,许祥丽.功能性消化不良患者胃窦部容积和胃排空时间与临床关系的超声评估.临床超声医学杂志,2007,9(10):584-587.
[12]Marciani L,Coleman NS,Dunlop SP,et al.Gallbladder contraction,gastric emptying and antral motility:single visit assessment of upper GI function in untreated celiac disease using echo-planar MRI.J Magn Reson Imaging,2005,22:634-638.
[13]Marciani L,Gowland PA,Spiller RC,et al.Effect of meal viscosity and nutrients on satiety,intragastric dilution,and emptying assessed by MRI.Am J Physiol Gastrointest Liver Physiol,2001,280:G1227-1233.
[14]Kunz P,Feinle C,Schwizer W,et al.Assessment of gastric motor function during the emptying of solid and liquid meals in humans by MRI.J Magn Reson Imaging,1999,9:75-80.
[15]Feinle C,Kunz P,Boesiger P,et al.Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans.Gut,1999,44:106-111.
[16]FeldmanM.Smith HJ,Simon YR.Gastric emptying of solid radio-opaque markers:studies in healthy subjecrs and diabetic patients.Gastroenterology,1984,87(4):895-902.
[17]Urbrain JC,Siegel JA,Charkes ND,et al.The two component stomachs:effects of meal particle size on fundal and antral emptying.Eur J Nucl Med,1989,15:254-259.
[18]郭建强,柯美云,秦明伟.等.胃中间横带对近端胃和远端胃食物分布的调节作用.中国医学科学院学报,2000,22(5):416-420.
[19]Moore J G,Dubos A,Christian P E,et al.Evidence for a midgastrict ransverse band in human.Gastroenterology,1986,91:540-545.
[20]Collins PJ,Horowitz M,Chatterton B E.Proximal,distal and total stomach emptying of a digestible solidmeal in normal subjects.Br J Radiol,1988,61:12-18.
[21]严祥,刘纯,刘永铭,等.胃中间横带在胃排空中的作用及机制探讨.中华核医学杂志,2000,20:29-30。
[22]Indiresh K K,Brasseur J G,Faas H,et al.Relative contributions of "pressure pump" and "peristaltic pump" to galtric emptying.Am J Physiol Gastrointest Liver Physiol,2000,278:604-616.
[23]严祥,刘纯,刘永铭,等.胃排空延迟与胃中间横带关系及作用机制研究.兰州大学学报(医学版),2005,31(2)1-4.
[24]王秀杰,王学清,李岩,等.半夏泻心汤及拆方对小鼠胃排空影响的实验研究.中华中医药学刊,2008,26(5):1072-1073.
[25]Troncon LE,Bennett RJ,Ahluwalia NK,Thompson DG.Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients.Gut,1994,35:327-332.
[26]秦家琨,张留印,吴大桢,等.低钡硬餐X线检查诊断功能性消化不良.新乡医学院学报,2001,18(5):343-344.
[1]邹多武,许国铭.功能性消化不良.中华消化杂志,2006,26(11):765-767.
[2]江鸿志.重视对功能性消化不良的研究.中华内科杂志,1998,37(8):509.
[3]Sarnelli G,Caenepeel P,Geypens B,Janssens J,Tack J.Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.Am J Gastroenterol,2003,98:783-788.
[4]Tack J,Piessevaux H,Coulie B,Caenepeel P,Janssens J.Role of impaired gastric accommodation to a meal in functional dyspepsia.Gastroenterology,1998,115:1346-1352.
[5]Akkermans LM,van Isselt JW.Gastric motility and emptying studies with radionuclides in research and clinical settings.Dig Dis Sci,1994,39:95S-96S.
[6]Lipp RW,Hammer HF,SchnedlW,et al.A simple scintigraphic method for continus monitoring of gastric emptying.Eur J NuclMed,1993,20:260-263.
[7]敬兴果,古赛,雷成明.核素~(99m)Tc-DTPA液体胃排空测定法的临床价值探讨.重庆医学,2008,37(2):310-311.
[8]Tougas G,Chen Y,Coates G,et al.Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting.Am J Gastroenterol,2000,95:78-86.
[8]刘纯,严祥,陈明,等.影像确定胃中间横带靶区轮廓的因素.兰州大学学报(医学版),2007,33(2)30-33.
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[10]FeldmanM.Smith HJ,Simon TR.Gastric emptying of solid radio-opaque markers:studies in healthy subjecrs and diabetic patients,Gastroentero logy,1984,87(4):895-899.
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[13]赵英华,曹晓焱,郭宝生.功能性消化不良胃动力学的超声检测.吉林医学,2006,27(11):1333-1334.
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[15]Marciani L,Coleman NS,Dunlop SP,et al.Gallbladder contraction,gastric emptying and antral motility:single visit assessment of upper GI function in untreated celiac disease using echo-planar MRI.J Magn Reson Imaging,2005,22:634-638.
[16]Marciani L,Gowland PA,Spiller RC,et al.Effect of meal viscosity and nutrients on satiety,intragastric dilution,and emptying assessed by MRI.Am J Physiol Gastrointest Liver Physiol,2001,280:G1227-1233.
[17]Kunz P,Feinle C,Schwizer W,et al.Assessment of gastric motor function during the emptying of solid and liquid meals in humans by MRI.J Magn Reson Imaging:1999,9:75-80.
[18]Feinle C,Kunz P,Boesiger P,et al.Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans.Gut,1999,44:106-111.
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[2]江鸿志.重视对功能性消化不良的研究.中华内科杂志,1998,37(8):509.
[3]Sarnelli G,Caenepeel P,Geypens B,Janssens J,Tack J.Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.Am J Gastroenterol,2003,98:783-788.
[4]Tack J,Piessevaux H,Coulie B,Caenepeel P,Janssens J.Role of impaired gastric accommodation to a meal in functional dyspepsia.Gastroenterology,1998,115:1346-1352.
[5]左国文,覃江,农兵,等.功能性消化不良胃电活动的临床观察.临床荟萃,2004,19:1150-1151.
[6]陈波,张建忠,万小平,等.功能性消化不良患者胃十二指肠运动功能的研究[J].胃肠病学和肝病学杂志,2000,9(4):267-269.
[7]朱良如,谢小平,侯晓华.功能性消化不良患者胃机械感觉过敏.胃肠病学,2006,11:30-33.
[8]孙燕,侯晓华.内脏感觉过敏与功能性胃肠病.临床内科杂志,2005,22(5):359-360.
[9]Akkermans LM,van Isselt JW.Gastric motility and emptying studies with radionuclides in research and clinical settings.Dig Dis Sci,1994,39:95S-96S.
[10]Tougas G,Chen Y,Coates G,et al.Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting.Am J Gastroenterol,2000,95:78-86.
[11]郑敏,许祥丽.功能性消化不良患者胃窦部容积和胃排空时间与临床关系的超声评估.临床超声医学杂志,2007,9(10):584-587.
[12]Marciani L,Coleman NS,Dunlop SP,et al.Gallbladder contraction,gastric emptying and antral motility:single visit assessment of upper GI function in untreated celiac disease using echo-planar MRI.J Magn Reson Imaging,2005,22:634-638.
[13]Marciani L,Gowland PA,Spiller RC,et al.Effect of meal viscosity and nutrients on satiety,intragastric dilution,and emptying assessed by MRI.Am J Physiol Gastrointest Liver Physiol,2001,280:G1227-1233.
[14]Kunz P,Feinle C,Schwizer W,et al.Assessment of gastric motor function during the emptying of solid and liquid meals in humans by MRI.J Magn Reson Imaging,1999,9:75-80.
[15]Feinle C,Kunz P,Boesiger P,et al.Scintigraphic validation of a magnetic resonance imaging method to study gastric emptying of a solid meal in humans.Gut,1999,44:106-111.
[16]FeldmanM.Smith HJ,Simon YR.Gastric emptying of solid radio-opaque markers:studies in healthy subjecrs and diabetic patients.Gastroenterology,1984,87(4):895-902.
[17]Urbrain JC,Siegel JA,Charkes ND,et al.The two component stomachs:effects of meal particle size on fundal and antral emptying.Eur J Nucl Med,1989,15:254-259.
[18]郭建强,柯美云,秦明伟.等.胃中间横带对近端胃和远端胃食物分布的调节作用.中国医学科学院学报,2000,22(5):416-420.
[19]Moore J G,Dubos A,Christian P E,et al.Evidence for a midgastrict ransverse band in human.Gastroenterology,1986,91:540-545.
[20]Collins PJ,Horowitz M,Chatterton B E.Proximal,distal and total stomach emptying of a digestible solidmeal in normal subjects.Br J Radiol,1988,61:12-18.
[21]严祥,刘纯,刘永铭,等.胃中间横带在胃排空中的作用及机制探讨.中华核医学杂志,2000,20:29-30。
[22]Indiresh K K,Brasseur J G,Faas H,et al.Relative contributions of "pressure pump" and "peristaltic pump" to galtric emptying.Am J Physiol Gastrointest Liver Physiol,2000,278:604-616.
[23]严祥,刘纯,刘永铭,等.胃排空延迟与胃中间横带关系及作用机制研究.兰州大学学报(医学版),2005,31(2)1-4.
[24]王秀杰,王学清,李岩,等.半夏泻心汤及拆方对小鼠胃排空影响的实验研究.中华中医药学刊,2008,26(5):1072-1073.
[25]Troncon LE,Bennett RJ,Ahluwalia NK,Thompson DG.Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients.Gut,1994,35:327-332.
[26]秦家琨,张留印,吴大桢,等.低钡硬餐X线检查诊断功能性消化不良.新乡医学院学报,2001,18(5):343-344.
[1]邹多武,许国铭.功能性消化不良.中华消化杂志,2006,26(11):765-767.
[2]江鸿志.重视对功能性消化不良的研究.中华内科杂志,1998,37(8):509.
[3]Sarnelli G,Caenepeel P,Geypens B,Janssens J,Tack J.Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia.Am J Gastroenterol,2003,98:783-788.
[4]Tack J,Piessevaux H,Coulie B,Caenepeel P,Janssens J.Role of impaired gastric accommodation to a meal in functional dyspepsia.Gastroenterology,1998,115:1346-1352.
[5]Akkermans LM,van Isselt JW.Gastric motility and emptying studies with radionuclides in research and clinical settings.Dig Dis Sci,1994,39:95S-96S.
[6]Lipp RW,Hammer HF,SchnedlW,et al.A simple scintigraphic method for continus monitoring of gastric emptying.Eur J NuclMed,1993,20:260-263.
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