超声胃功能检测诊断糖尿病胃轻瘫的临床研究
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摘要
目的探讨应用超声胃功能检测诊断糖尿病患者胃轻瘫的价值。方法 30例糖尿病患者及30例健康志愿者(对照组)饮用速溶超声助显剂500 m L后,测量其胃底及胃体横断面面积及胃窦内径,30 min、60min后重复以上测量,计算胃底及胃体面积缩小率及观测胃窦内径变化情况。结果胃底、胃体横断面面积及胃窦直径糖尿病组及对照组差异无统计学意义(P> 0. 05); 30 min、60 min后,糖尿病组胃底面积缩小率与胃体面积缩小率均小于对照组,两者差异有统计学意义(P <0. 05); 30 min、60 min后,胃窦内径在糖尿病组与对照组差异均无统计学意义(P> 0. 05)。结论糖尿病患者胃排空减慢,超声胃功能检测可以诊断糖尿病胃轻瘫。
Objective To diagnose the diabetic gastroparesis with ultrasonic examination of gastric function.Methods The cross sectional area of fundus and body of stomach and diameter of antrum of stomach to 30 diabetics after they drank 500 m L instant gastric ultrasonic developer were measured,then the above measurement 30 min and 60 min later repeated respectively. The area reduce rates of fundus and body of stomach calculated and the inner diameter change of antrum of stomach observed. Thirty healthy volunteers were selected as controls. Results The cross sectional area of fundus and body of stomach and diameter of antrum of stomach were all similar between disease group and control group( P > 0. 05); after 30 min and 60 min,the area reduce rates of fundus and body of stomach in disease group were all less than those in control group differently( P < 0. 05); the inner diameter of antrum of stomach was similar between disease group and control group after 30 min and 60 min( P > 0. 05). Conclusion Gastric emptying is delayed in diabetic patients. Abdominal ultrasound can help diagnose the diabetic gastroparesis with gastric ultrasonic developer.
Objective To diagnose the diabetic gastroparesis with ultrasonic examination of gastric function.Methods The cross sectional area of fundus and body of stomach and diameter of antrum of stomach to 30 diabetics after they drank 500 m L instant gastric ultrasonic developer were measured,then the above measurement 30 min and 60 min later repeated respectively. The area reduce rates of fundus and body of stomach calculated and the inner diameter change of antrum of stomach observed. Thirty healthy volunteers were selected as controls. Results The cross sectional area of fundus and body of stomach and diameter of antrum of stomach were all similar between disease group and control group( P > 0. 05); after 30 min and 60 min,the area reduce rates of fundus and body of stomach in disease group were all less than those in control group differently( P < 0. 05); the inner diameter of antrum of stomach was similar between disease group and control group after 30 min and 60 min( P > 0. 05). Conclusion Gastric emptying is delayed in diabetic patients. Abdominal ultrasound can help diagnose the diabetic gastroparesis with gastric ultrasonic developer.
引文
[1]PARKMAN H P,HALLINAN E K,HASLER W L,et al.Nausea and vomiting in gastroparesis:similarities and differences in idiopathic and diabetic gastroparesis[J].Neurogastroenterol Motil,2016,28(12):1902-1914.
[2]KASSANDER P.Asymptomatic gastric retention in diabetics(gastroparesis diabeticorum)[J].Ann Intern Med,1958,48(4):797-812.
[3]KASHYAP P,FARRUGIA G.Diabetic Gastroparesis:what we have learned and had to unlearn in the past 5 years[J].Gut,2010,59(12):1716-1726.
[4]高美莹,苗立英,葛辉玉,等.胃间质瘤超声造影表现与良恶性的相关性分析[J].中国超声医学杂志,2017,33(2):184-186.
[5]马懿,卢漫,蔡志清,等.应用胃充盈超声检查对胃癌术前TNM分期的临床研究[J].实用医院临床杂志,2012,9(4):63-66.
[6]沈理,汪晓虹,王怡.我国胃疾病超声诊断的现状与展望[J/CD].中华医学超声杂志:电子版,2016,13(6):401-405.DOI:10.3877/cma.j.issn.1672-6448.2016.06.001.
[7]韩蕊君,李凤华,牛永华,等.口服胃肠超声造影评价尿毒症患者胃肠动力及胃壁形态改变[J].中国医学影像学杂志,2012,20(4):286-289.
[8]ERSOY B,SAYIT E,CAN S,et al.Gastric emptying of solids and its relationship with microalbuminuria in children and adolescents with type 1 diabetes mellitus[J].JDiabetes,2013,5(5):319-324.
[9]HAFEEZ M,HUSSAIN F,SALAMAT A.Gastric emptying scintigraphy in postprandial distress syndrome[J].Pak JMed Sci,2018,34(1):1-5.
[10]MURESAN C,BLAGA T S,MURESAN L,et al.Abdominal ultrasound for the evaluation of gastric emptying revisited[J].J Gastrointest Liver,2015,24(3):329-338.
[11]MANINI M L,BURTON D D,MEIXNER D D,et al.Feasibility and application of 3-dimensional ultrasound for measurement of gastric volumes in healthy adults and adolescents[J].J Pediatr Gastr Nutr,2009,48(3):287-293.
[12]FAN X P,WANG L,ZHU Q,et al.Sonographic evaluation of proximal gastric accommodation in patients with functional dyspepsia[J].World J Gastroentero,2013,19(29):4774-4780.
[13]NESHATIAN L,GIBBONS S J,FARRUGIA G.Macrophages in diabetic gastroparesis-the missing link?[J].JNeurogastroenterol,2015,27(1):7-18.
[14]GIBBONS S J,GROVER M,CHOI K M,et al.Repeat polymorphisms in the Homo sapiens heme oxygenase-1 gene in diabetic and idiopathic gastroparesis[J].PLo S One,2017,12(11):1-6.
[15]ASANO T,AIDA S,SUEMASU S,et al.Aldioxa improves delayed gastric emptying and impaired gastric compliance,pathophysiologic mechanisms of functional dyspepsia[J].Sci Rep-UK,2015,5:17519.
[16]杨晓晖,丛佳林.糖尿病胃轻瘫的诊断与处理[J].中华全科医学,2017,15(3):369-370.
[17]HORN C C,ZIRPEL L,SCIULLO M,et al.Impact of electrical stimulation of the stomach on gastric distension-induced emesis in the musk shrew[J].J Neurogastroenterol,2016,28(8):1217-1232.
[18]CAMILLERI M,PARKMAN H P,SHAFI M A,et al.Clinical guideline:management of gastroparesis[J].Am JGastroenterol,2013,108(1):18-38.
[2]KASSANDER P.Asymptomatic gastric retention in diabetics(gastroparesis diabeticorum)[J].Ann Intern Med,1958,48(4):797-812.
[3]KASHYAP P,FARRUGIA G.Diabetic Gastroparesis:what we have learned and had to unlearn in the past 5 years[J].Gut,2010,59(12):1716-1726.
[4]高美莹,苗立英,葛辉玉,等.胃间质瘤超声造影表现与良恶性的相关性分析[J].中国超声医学杂志,2017,33(2):184-186.
[5]马懿,卢漫,蔡志清,等.应用胃充盈超声检查对胃癌术前TNM分期的临床研究[J].实用医院临床杂志,2012,9(4):63-66.
[6]沈理,汪晓虹,王怡.我国胃疾病超声诊断的现状与展望[J/CD].中华医学超声杂志:电子版,2016,13(6):401-405.DOI:10.3877/cma.j.issn.1672-6448.2016.06.001.
[7]韩蕊君,李凤华,牛永华,等.口服胃肠超声造影评价尿毒症患者胃肠动力及胃壁形态改变[J].中国医学影像学杂志,2012,20(4):286-289.
[8]ERSOY B,SAYIT E,CAN S,et al.Gastric emptying of solids and its relationship with microalbuminuria in children and adolescents with type 1 diabetes mellitus[J].JDiabetes,2013,5(5):319-324.
[9]HAFEEZ M,HUSSAIN F,SALAMAT A.Gastric emptying scintigraphy in postprandial distress syndrome[J].Pak JMed Sci,2018,34(1):1-5.
[10]MURESAN C,BLAGA T S,MURESAN L,et al.Abdominal ultrasound for the evaluation of gastric emptying revisited[J].J Gastrointest Liver,2015,24(3):329-338.
[11]MANINI M L,BURTON D D,MEIXNER D D,et al.Feasibility and application of 3-dimensional ultrasound for measurement of gastric volumes in healthy adults and adolescents[J].J Pediatr Gastr Nutr,2009,48(3):287-293.
[12]FAN X P,WANG L,ZHU Q,et al.Sonographic evaluation of proximal gastric accommodation in patients with functional dyspepsia[J].World J Gastroentero,2013,19(29):4774-4780.
[13]NESHATIAN L,GIBBONS S J,FARRUGIA G.Macrophages in diabetic gastroparesis-the missing link?[J].JNeurogastroenterol,2015,27(1):7-18.
[14]GIBBONS S J,GROVER M,CHOI K M,et al.Repeat polymorphisms in the Homo sapiens heme oxygenase-1 gene in diabetic and idiopathic gastroparesis[J].PLo S One,2017,12(11):1-6.
[15]ASANO T,AIDA S,SUEMASU S,et al.Aldioxa improves delayed gastric emptying and impaired gastric compliance,pathophysiologic mechanisms of functional dyspepsia[J].Sci Rep-UK,2015,5:17519.
[16]杨晓晖,丛佳林.糖尿病胃轻瘫的诊断与处理[J].中华全科医学,2017,15(3):369-370.
[17]HORN C C,ZIRPEL L,SCIULLO M,et al.Impact of electrical stimulation of the stomach on gastric distension-induced emesis in the musk shrew[J].J Neurogastroenterol,2016,28(8):1217-1232.
[18]CAMILLERI M,PARKMAN H P,SHAFI M A,et al.Clinical guideline:management of gastroparesis[J].Am JGastroenterol,2013,108(1):18-38.