摘要
背景:肝硬化患者食管胃静脉曲张内镜治疗后消化不良症状明显,胃电节律、自主神经功能失衡在其中的作用尚不明确。目的:探讨肝硬化患者食管胃静脉曲张内镜治疗后胃电节律、自主神经功能的变化。方法:选取2019年5月—2019年10月南京医科大学第一附属医院收治的25例肝硬化食管胃静脉曲张患者,以10例胃息肉患者作为对照。肝硬化食管胃静脉曲张患者术前、术后1 d、术后5 d分别行胃电图(EGG)、心率变异性(HRV)检查;胃息肉患者术前、术后1 d分别行EGG、HRV检查。比较两组患者治疗前后胃电节律和自主神经功能变化。结果:食管胃静脉曲张组与胃息肉组术前、术后1 d胃电节律、自主神经功能无明显差异(P>0.05)。与术前相比,食管胃静脉曲张组术后1 d LF、LF/HF明显升高(P<0.05),HF明显下降(P<0.01),EGG过缓比例显著增加(P<0.01);术后5 d胃电节律和自主神经功能无明显改变(P>0.05)。胃息肉组术后1 d胃电节律和自主神经功能与术前相比均无明显差异(P>0.05)。Child-Pugh B级患者胃电节律紊乱较Child-Pugh A级患者更严重(P<0.05)。结论:肝硬化患者食管胃静脉曲张内镜治疗后1 d胃电过缓比例升高,自主神经功能比例失调,交感神经活性升高,迷走神经活性下降。提示肝硬化患者食管胃静脉曲张内镜治疗后胃电节律和自主神经功能紊乱可能与消化不良症状有关。
Background: The occurrence of gastrointestinal symptoms in cirrhotic patients with gastroesophageal varices (GOV) after endoscopic treatment is obvious, and the role of gastric myoelectrical activity (GMA) and autonomic nerve function imbalance in the development of gastrointestinal symptoms has not been clarified. Aims: To investigate the changes of GMA and autonomic nerve function in cirrhotic patients with GOV after endoscopic treatment. Methods: Twenty-five cirrhotic patients with GOV from May 2019 to October 2019 at the First Affiliated Hospital of Nanjing Medical University were enrolled, and 10 patients with gastric polyp were served as controls. Electrogastrogram (EGG) and heart rate variability (HRV) were detected before the operation, 1 day after the operation and 5 days after the operation in GOV group. For the gastric polyp group, EGG and HRV were detected before the operation and 1 day after the operation. Changes of GMA and autonomic nerve function were compared between the two groups. Results: No significant differences in GMA and autonomic nerve function were found between GOV group and gastric polyp group before and 1 day after the operation (P>0.05). LF, LF/HF were significantly increased 1 day after the operation in GOV group (P<0.05), while HF was significantly decreased (P<0.01), and the percentage of bradygastria was significantly increased (P<0.01). There were no significant differences in GMA and autonomic nerve function between pre-operation and 5 days after the operation in GOV group (P>0.05). There were no significant differences in GMA and autonomic nerve function 1 day after the operation compared with pre-operation in gastric polyp group (P>0.05). Compared with Child-Pugh A group, Child-Pugh B group had more obvious GMA abnormalities, and the difference was statistically significant (P<0.05). Conclusions: In cirrhotic patients with GOV, the percentage of bradygastria and the sympathetic activity increased, and the vagal activity decreased 1 day after the operation. These results sugg
作者
李梦羽
陈怡
刘梅红
王美峰
张道权
程文芳
姜柳琴
周希乔
LI Mengyu;CHEN Yi;LIU Meihong;WANG Meifeng;ZHANG Daoquan;CHENG Wenfang;JIANG Liuqin;ZHOU Xiqiao(Department of Gastroenterology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,210029)
出处
《胃肠病学》
2020年第10期601-605,共5页
Chinese Journal of Gastroenterology
基金
国家自然科学基金(81570522)
江苏省卫健委强卫工程青年人才(QNRC2016568)。
关键词
肝硬化
食管和胃静脉曲张
内镜治疗
胃电节律
自主神经功能
Liver Cirrhosis
Esophageal and Gastric Varices
Endoscopic Treatment
Gastric Myoelectrical Activity
Autonomic Nerve Function
