PYLORIC DYSFUNCTION IN DIABETICS WITH RECURRENT NAUSEA AND VOMITING
PYLORIC DYSFUNCTION IN DIABETICS WITH RECURRENT NAUSEA AND VOMITING
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DOI：
10.1016/0016-5085(86)90262-3
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发表时间：
1986-06-01
期刊：
影响因子：
29.4
通讯作者：
MALAGELADA, JR
中科院分区：
文献类型：
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作者：
MEARIN, F;CAMILLERI, M;MALAGELADA, JR
糖尿病与多种胃肠运动障碍有关。然而，幽门活性尚未进行专门研究。我们对24例有反复恶心或呕吐，或两者兼有但无机械性梗阻证据的糖尿病患者进行了幽门测压。12名健康志愿者作为对照。一个多腔气动液压灌注组件与五个侧开口，每一个1厘米的距离，被定位在荧光透视横跨胃窦十二指肠交界处，并用于监测压力活动5小时（3小时禁食和2小时进食）。定义并量化了幽门活动的三种模式：（a）基线升高≥≥ 3 mmHg 1 min（强直模式）;（B）与十二指肠相位活动混合的胃窦型相位压力活动（相位模式）;和（c）叠加在强直活动上的相位模式（组合的强直-相位模式）。糖尿病患者餐前和餐后总幽门活动的持续时间均大于对照组（P < 0.005）。此外，异常长时间（≥ 10分钟）的3分钟）和强烈（≥ 3分钟）。24例糖尿病患者中有14例出现强直性收缩，即“幽门痉挛”，而对照组中仅1例（p = 0.025）。在糖尿病患者中，幽门痉挛发作时强直活动的峰值幅度为13 ± 1.5。1 mmHg，持续时间为7 ±。0.7 min（平均值±）SE）。我们的结论是幽门动力障碍的形式的一部分，影响一些糖尿病患者的肠道动力的广泛破坏。
Diabetes mellitus has been associated with a variety of gastrointestinal motor disturabances. Pyloric acitivity, however, has not been specifically investigated. We have quantified the pyloric manometric profile in 24 diabetics with recurrent nausea or vomiting, or both without evidence of mechanical obstruction. Twelve healthy volunteers served as controls. A multilumen pneumohydraulic perfusion assembly with five side openings, each 1 cm apart, was positioned fluoroscopically across the antroduodenal junction and used to monitor pressure activity for 5 h (3 h fasting and 2 h fed). Three patterns of pyloric activity were defined and quantified: (a) baseline elevation of .gtoreq. 3 mmHg for .gtoreq. 1 min (tonic pattern); (b) antral-type phasic pressure activity mixed with duodenal phasic activity (phasic pattern); and (c) phasic pattern superimposed on tonic activity (combined tonic-phasic pattern). The duration of the total pyloric activity before and after the meal was greater in diabetics than in controls (p < 0.005). Furthermore, episodes of unusually prolonged (.gtoreq. 3 min) and intense (.gtoreq. 10 mmHg) tonic contraction, "pylorospasm", were observed in 14 of 24 diabetics but in only 1 control (p = 0.025). In diabetics, episodes of pylorospasm had a peak amplitude of tonic activity of 13 .+-. 1 mmHg and a duration of 7 .+-. 0.7 min (mean .+-. SE). We conclude that pyloric dysmotility forms part of the widespread disruption of gut motility that affects some patients with diabetes.