SLEEP AND DUODENAL MOTOR-ACTIVITY IN PATIENTS WITH SEVERE NONULCER DYSPEPSIA
SLEEP AND DUODENAL MOTOR-ACTIVITY IN PATIENTS WITH SEVERE NONULCER DYSPEPSIA
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DOI：
10.1136/gut.35.7.916
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发表时间：
1994-07-01
期刊：
影响因子：
24.5
通讯作者：
MAYER, EA
中科院分区：
文献类型：
--
作者：
DAVID, D;MERTZ, H;MAYER, EA
研究了严重非溃疡性消化不良患者睡眠障碍的患病率。还考虑了睡眠模式的变化是否与胃肠道节律性禁食运动活动的变化相关，以及运动事件是否与患者的症状相关。在十二指肠的运动活动进行了监测，在24小时内自由走动的条件下，在10名健康对照组和10例严重的非溃疡性消化不良患者使用经鼻放置的导管与6个固态压力传感器连接到一个数字数据记录设备。通过问卷和日记评估症状和睡眠障碍。根据其症状，将患者分为两组：仅具有消化不良症状的患者（非溃疡性消化不良; n=5）和具有消化不良和被认为来自下消化道的其他功能性症状的患者（非溃疡性消化不良+肠易激综合征; n=5）。与对照组或非溃疡性消化不良+肠易激综合征组相比，非溃疡性消化不良患者夜间移行性运动复合波的数量显著减少（0.7 v4.6），夜间I相百分比降低（5.2% v78.0%），夜间II相百分比增加（94% v15.4%）。非溃疡性消化不良+肠易激综合征患者与正常对照组无差异。4名非溃疡性消化不良患者和所有非溃疡性消化不良+肠易激综合征患者报告了睡眠困难。在研究期间，两组中的几名患者均观察到不伴有主观不适的高振幅强直性和相位性群集。在10名患者中，有8名患者在正常活动期间报告腹部疼痛，而在1名患者中，疼痛与移行性运动复合体的III期相关。与先前肠易激综合征患者的报告相反，提示慢性腹痛患者的节律性异常-表现为睡眠改变和十二指肠运动活动节律改变-被认为是由上消化道引起的。
The prevalence of sleep disturbances was studied in patients with severe non-ulcer dyspepsia. It was also considered if the change in sleep pattern was associated with changes in the rhythmic fasting motor activity of the gastrointestinal tract, and if motor events correlate with the patient's symptoms. Motor activity in the duodenum was monitored over a 24 hour period under freely ambulatory conditions in 10 healthy controls and in 10 patients with severe non-ulcer dyspepsia using a transnasally placed catheter with six solid state pressure transducers connected to a digital data logging device. Symptoms and sleep disturbance were assessed by questionnaire and diary. Based on their symptoms, the patients were separated into two groups: those with dyspepsia symptoms only (non-ulcer dyspepsia; n=5) and those with dyspepsia and additional functional symptoms thought to from the lower gastrointestinal (non-ulcer dyspepsia+irritable bowel syndrome; n=5). When compared with either the control or the non-ulcer dyspepsia+irritable bowel syndrome group, non-ulcer dyspepsia patients had a considerably decreased number of migrating motor complexes during the nocturnal period (0.7 v 4.6), a decreased percentage of nocturnal phase I (5.2% v 78.0%), and an increased percentage of the nocturnal period in phase II (94% v 15.4%). Patients with non-ulcer dyspepsia+irritable bowel syndrome were not different from normal controls. Four of the non-ulcer dyspepsia patients and all of the non-ulcer dyspepsia+irritable bowel syndrome patients reported difficulties with sleep. Clusters of high amplitude tonic and phasic not accompanied by subjective of discomfort were noted in several patients in both groups during the study. In eight of 10 patients, abdominal reported during normal activity, while in one patient, pain correlated with phase III of the migrating motor complex. In contrast with previous reports in patients with irritable bowel syndrome, suggest an abnormality rhythmicity - shown in changed sleep and changed rhythmic duodenal motor activity - in patients with chronic abdominal pain thought to arise from the upper gastrointestinal tract.