Study Of Gastric Dysmotility And Relationship Between It And Gastrointestinal Hormones In Patients With Functional Dyspepsia

Functional dyspepsia (FD) is a common syndrome,occuring in 20%~40% of patiens with digestive diseases, with a significant impact on quality of life,and a hot problem studied all the way. Published recently, the Rome II classification system of functional gastrointestinal disorders is the diagnostic criteria based on symptoms . According to the Rome II criteria, functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen for 12 or more weeks in the past 12 months, without evidence of organic disease likely to explain the symptoms including at upper endoscopy,unrelated to defecation. Based on the predominant symptom, functional dyspepsia is subdivided into 3 symptom subgroups: (a) ulcer-like dyspepsia when pain is the predominant symptom; (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom .including upper abdominal fullness, early satiety, nausea; (c) unspecified dyspepsia. A major change was in the more recent Rome II reports, in which the symptoms heartburn, acid regurgitation, were excluded from the definition of dyspepsia because of their relation to gastroesophageal reflux disease (GERD).The factors giving rise to such symptoms may be multiple. Recently, research papers at home and abroad showed that gastrointestinal dysmotility play a main role in pathogenesis of functional dyspepsia . Nevertheless,there is a fewer reports of systemic-6-study on the relationship between gastrointestinal dysmotility and gastrointestinal hormones ,and certain pathogenesis of functional dyspepsia remain unclear. In the present study, we explored gastric dysmotility and relationship between it and gastrointestinal hormones in patients with functional dyspepsia, by synchronous observation of changs of gastric emptying, electrogastrogram and blood levels of partial gastrointestinal hormones in 3 subgroups of functional dyspepsia according to the last Rome II criteria at the first time.Methods:The patients with FD were divided into 3 subgroups according to the Rome II criteria and 10 cases were selected randomly from each subgroup,then 4 groups were set up including the ulcer-like dyspepsia group(10 cases), the dysmotility-like dyspepsia group(10 cases), the unspecified dyspepsia dyspepsia group(10 cases) and the control group(10 health subjects) observing synchronously changs of gastric emptying, electrogastrogram and blood levels of partial gastrointestinal hormones. After measuring gastric emptying, 30 cases of FD were divided into 2 groups, the gastric emptying normal group and the gastric emptying delay group. Changs in motilin (MLT), somatostatin (SS) , substance? (SP) and nitric oxide (NO) contents in peripheral blood were determined by radioimmunoassay and nitrate reductase technique. Electrogastrograms were recorded by electrogastrogram meter, gastric emptying applying ""Tc-labelled solid food to test.Results:(1) In the ulcer-like group, gastric emptying is slow (40%), while gastric emptying time of half (GET, 7) and every time-point gastric emptying rate (GE%) didn't show significant chang (/*>0.05) and not significant difference (.PXX05) among 3-1 -subgroups of FD: as for electrogastrogram, post-meal average amplitude (AP)decreased significantly (.PO.05), meanwhile difference of average amplitude (Z^AP) reduced significantly between pre-meal and post- meal (PO.05), whereas pre-meal and post-meal average frequency (FZ) ,pre-meal average amplitude (AP) didn't show significant chang (P>0.05); contents of SS in peripheral blood increased significantly(PO.05), contents of MIL, SP, NO didn't show significant chang (P>0.05) .(2) In the dysmotility-like group, gastric emptying is slow (70%), meanwhile GET! 2 prolonged significantlyC P<0.05), GE% decreased significantly (15min P>0.05, SOmin P>0.05, 45min P<0.05, 60min P<0.05, 90min PO.01 and 120 min P<0.01 respectively); as for electrogastrogram, post-meal AP decreased significantly(.P<0.05), meanwhile AAP reduced significantly (PO.05), whereas pre-meal and post- mea...