Gastroparesis
Gastroparesis
复制标题
DOI：
10.1038/s41572-018-0038-z
复制
发表时间：
2018-11-01
影响因子：
81.5
通讯作者：
Stanghellini, Vincenzo
中科院分区：
文献类型：
--
作者：
Camilleri, Michael;Chedid, Victor;Stanghellini, Vincenzo
胃轻瘫是一种疾病，其特征是在没有胃的机械性阻塞的情况下固体食物的胃排空延迟，导致早饱、餐后饱胀、恶心、呕吐、打嗝和腹胀的主要症状。胃轻瘫现在被认为是更广泛的胃神经肌肉功能障碍的一部分，包括胃调节受损。上消化道症状之间的重叠使得胃轻瘫和其他疾病（如功能性消化不良）之间的区分具有挑战性。因此，胃轻瘫的确诊需要通过适当的测试（如胃排空造影或呼吸测试）测量胃排空延迟。胃轻瘫可具有特发性、糖尿病性、医源性、手术后或病毒感染后病因。胃轻瘫的管理包括：纠正液体、电解质和营养缺乏;识别和治疗胃排空延迟的原因（例如糖尿病）;以及使用药物作为一线治疗来抑制或消除症状。几种新的药物和干预措施目前正在筹备中，并显示出为胃轻瘫患者提供个性化治疗的希望。
Gastroparesis is a disorder characterized by delayed gastric emptying of solid food in the absence of a mechanical obstruction of the stomach, resulting in the cardinal symptoms of early satiety, postprandial fullness, nausea, vomiting, belching and bloating. Gastroparesis is now recognized as part of a broader spectrum of gastric neuromuscular dysfunction that includes impaired gastric accommodation. The overlap between upper gastrointestinal symptoms makes the distinction between gastroparesis and other disorders, such as functional dyspepsia, challenging. Thus, a confirmed diagnosis of gastroparesis requires measurement of delayed gastric emptying via an appropriate test, such as gastric scintigraphy or breath testing. Gastroparesis can have idiopathic, diabetic, iatrogenic, post-surgical or post-viral aetiologies. The management of gastroparesis involves: correcting fluid, electrolyte and nutritional deficiencies; identifying and treating the cause of delayed gastric emptying (for example, diabetes mellitus); and suppressing or eliminating symptoms with pharmacological agents as first-line therapies. Several novel pharmacologic agents and interventions are currently in the pipeline and show promise to help tailor individualized therapy for patients with gastroparesis.