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Gastroenterology:功能性消化不良和胃轻瘫是可互换的综合征,具有常见的临床和病理特征

2021-05-14 MedSci原创 MedSci原创

传统上认为功能性消化不良(FD)是一种常见的综合征,可影响多达10%的普通人群,但其发病机理尚不清楚。

      传统上认为功能性消化不良(FD)是一种常见的综合征,可影响多达10%的普通人群,但其发病机理尚不清楚。但是,这些患者中有相当多的患者表现出胃轻瘫(Gp)症状(例如,恶心,呕吐,早饱和餐后饱胀),但发现其胃排空正常。慢性恶心和呕吐与胃排空延迟通称为胃轻瘫(Gp)。因此,本项研究试图采用新型的评价体系来区分两者的关系。

 

      在本项研究中研究人员对具有慢性上消化道症状的成年患者进行了48周的前瞻性随访。如果患者出现胃排空延迟,将患者归类为胃轻瘫。如果没有,如果他们符合罗马三世的标准,就被标记为患有FD。使用协方差分析和回归模型进行研究分析。

 

 

      研究人员在12年试验期间招募了944例患者,初步诊断为胃轻瘫的有720例(76%),FD的有224例(24%)。两组患者基线临床特征和上消化道症状的严重程度高度相似。48周的临床结果也相似,但是根据胃排空的结果,此时有42%初步诊断为胃轻瘫的患者被重新分类为FD。相反,37%的FD患者被重新分类为胃轻瘫。任一方向的变化与症状严重性变化的任何差异均不相关。与肥胖对照组相比,两组胃的全层活检均显示两组间Cajal和CD206 +巨噬细胞的间质细胞丢失程度较为严重。

图:不同患者胃排空时间的差异

 

       本项研究证实根据临床和病理特征或根据胃排空评估无法初次对于FD和胃轻瘫患者进行有效区分。FD和胃轻瘫由特征性病理特征统一起来,应被视为真正的胃神经肌肉疾病的一部分。

 

 

原始出处:

Pankaj J. Pasricha. Et al. Functional Dyspepsia and Gastroparesis in Tertiary Care are Interchangeable Syndromes With Common Clinical and Pathologic Features. Gastroenterology.2021.

 

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    2021-06-20 许安
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患者上腹胀闷多年,近来因情绪不佳导致病情加重,并恶心、厌油腻、胃口减退,多次胃镜示慢性非萎缩性胃炎,多次上腹B超示轻度脂肪肝,肝功能谷氨酰转肽酶轻度增高,CA242稍增高,是怎么一回事呢?

Am J Gastroenterol:ACG / CAG联合消化不良诊断和治疗指南

美国胃肠病学会(ACG)和加拿大胃肠病学协会(CAG)更新了ACG / CAG联合消化不良诊断和治疗指南

他是慢性胃炎还是功能性消化不良?

张先生,43岁。患有慢性胃病多年,近几年来常有上腹饱胀、嗳气、打嗝、烧心、反酸等症状,少量进食就有上腹饱胀感,时好时坏,多次到医院B超检查肝胆胰脾未发现异常,肝肾功能正常,多次胃镜检查诊断为“慢性浅表性胃炎’’(现在称为:慢性非萎缩性胃炎)。也无糖尿病、慢性肝炎等病史。

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