Abnormal sensitivity to duodenal lipid infusion in patients with functional dyspepsia
Abnormal sensitivity to duodenal lipid infusion in patients with functional dyspepsia
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DOI：
10.1097/00042737-199511000-00007
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发表时间：
1995-11-01
影响因子：
2.1
通讯作者：
Read, NW
中科院分区：
文献类型：
--
作者：
Barbera, R;Feinle, C;Read, NW
背景和目的：功能性消化不良患者对胃膨胀（机械感受器）和富含脂肪的食物（化学感受器）的敏感性增加。本研究的目的是测试这些患者是否对十二指肠内脂质异常敏感，以及这种刺激是否改变了胃的机械敏感性。方法与设计：采用10例患者和10例健康对照进行实验。在十二指肠输注10%脂内或0.9%生理盐水时，胃用松弛袋扩张。连续记录胃内压，并要求参与者报告胃的饱腹感和不适感。结果：患者和对照组在腹胀期间的胃内压分布相似。脂质降低了胃内压，降低了相收缩性。与对照组相比，在生理盐水和脂质输注期间，患者对胃膨胀的敏感性增强。在对照组中，脂质输注时饱腹感和不适的阈值体积高于生理盐水输注。在患者中，脂质输注时，饱腹感发生在较低的体积，而不适发生在相同的体积但较低的灌胃压力。大多数患者在脂质输注期间出现恶心和腹胀，3例患者呕吐，但在盐水输注期间无症状。对照组在两次输注期间均未报告出现症状。结论：消化不良患者对胃膨胀和十二指肠内脂质的敏感性均增加。与对照组相比，脂质使他们的胃对膨胀敏感。
Background and objectives: Patients with functional dyspepsia exhibit increased sensitivity to gastric distension (mechanoreceptors) and to meals rich in fat (chemoreceptors). The aim of this study was to test whether these patients were abnormally sensitive to intraduodenal lipid, and whether this stimulus altered gastric mechanosensitivity.Methods and design: Experiments were conducted on 10 patients and 10 healthy controls. The stomach was distended with a flaccid bag during duodenal infusion of either 10% Intralipid or 0.9% saline. Intragastric pressure was recorded continuously, and the participants were asked to report gastric sensations of fullness and discomfort.Results: Intragastric pressure profiles during distension were similar in patients and controls. Lipid decreased intragastric pressure and reduced phasic contractility. Patients showed enhanced sensitivity to gastric distension compared with controls during both saline and lipid infusions. In the controls, threshold volumes for fullness and discomfort were higher during lipid than saline infusion. In the patients, the sensation of fullness occurred at lower volumes during lipid infusion, whereas discomfort occurred at similar volumes but lower intragastric pressures. Most patients experienced nausea and bloating and three patients vomited during lipid infusion, but remained asymptomatic during saline infusion. Controls reported no symptoms during either infusion.Conclusion: Dyspeptic patients have increased sensitivity to both gastric distension and intraduodenal lipid. In contrast to controls, lipid sensitizes their stomachs to distension.