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proximal gastric motility in critically ill patients with type 2 diabetes mellitus

World Journal of Gastroenterology 2007年第2期13卷 270-275页

作者： Nam Q Nguyen Robert J Fraser Laura K Bryant Marianne Chapman Richard H Holloway Department of Gastroenterology Hepatology and General Medicine Royal Adelaide Hospital South Australia Investigation and Procedures Unit Repatriation General Hospital South Australia Anaesthesia and Intensive Care Royal Adelaide Hospital South Australia

AIM： To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with longstanding type 2 diabetes ***： proximal gastric motility was assessed （using a barostat） in 10 critically ill patients with type 2 diabetes mellitus （59±3 years） during two 60-min duodenal infusions of Ensure （1 and 2 kcal/min）, in random order, separated by 2h fasting. Data were compared with 15 non-diabetic critically ill patients （48 ± 5 years） and 10 healthy volunteers （28 ±3 years）. RESULTS： Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during I kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/ min infusion was initially reduced in diabetic patients （P 〈 0.05） but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic ***： In patients with diabetes mellitus, proximal gastric motility is less disturbed than nondiabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.

关键词： proximal gastric function Diabetes mellitus type 2 Critical illness Enteral nutrition

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Assessment of proximal gastric accommodation in patients with functional dyspepsia

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World Journal of Gastroenterology 2013年第47期19卷 9137-9138页

作者： Paola Iovino Antonella Santonicola Carolina Ciacci Gastrointestinal Unit Department of Medicine and SurgeryUniversity of Salerno84081 SalernoItaly Department of Clinical Medicine and Surgery University Federico Ⅱ of Naples80131 NaplesItaly

Impaired gastric accommodation is one of the most important etiologic factors in the pathophysiology of functional *** is a potential alternative method to study changes in gastric volume as a reflection of gastric *** is suitable for patients because it is a non-invasive,easily repeated and non-radioactive procedure,and a previous study has demonstrated the feasibility of 3-dimensional ultrasound in examining functional *** brief article by Fan et al demonstrated that both the proximal gastric area and volume,measured by 2-and 3-dimensional ultrasound respectively,were significantly smaller in patients with functional dyspepsia than in healthy *** results are very interesting,but we raise the relevant point that it should have been mandatory to study both changes in gastric volume and their relationship with upper gastrointestinal symptoms in functional *** fact,the relationship between cardinal symptoms and several pathophysiologic mechanisms in functional dyspepsia remains a matter of ***,further evaluation of distal gastric volume that has been previously implicated in the origin of functional dyspeptic symptoms is ***,impaired gastric accommodation does not serve as a clear marker of the cardinal symptoms experienced by patients with functional dyspepsia in daily life.

关键词： proximal gastric function gastric accommodation 2-Dimensional ultrasound 3-Dimensional ultrasound functional dyspepsia Rome III criteria

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