摘要
目的分析糖尿病胃轻瘫和糖尿病功能性消化不良患者胃电图检测结果,探讨胃电图对糖尿病胃轻瘫的诊断价值。方法选取2019年6月至2021年6月南京江北医院收治的60例合并胃轻瘫的糖尿病患者(观察组),60例合并功能性消化不良的糖尿病患者(对照组)作为研究对象。所有患者均在空腹状态、餐后接受体表胃电图检测,并接受X线钡餐造影检查、核素显像检查。比较两组的胃电图检测结果。比较钡餐造影、核素显像、胃电图对糖尿病患者胃轻瘫的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值,分析在糖尿病患者胃轻瘫诊断中钡餐造影、核素显像、胃电图诊断与临床综合诊断之间的一致性。结果在胃电图检测中,观察组的餐后/餐前功率比值、胃动过缓百分比均显著高于对照组(P<0.01),观察组餐前、餐后的波形反应面积均显著大于对照组(P<0.01)。核素显像与胃电图对糖尿病患者胃轻瘫的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值分别高于钡餐造影(P<0.01,P<0.05),而核素显像与胃电图的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值比较差异无统计学意义(P>0.05)。经一致性分析,在糖尿病患者胃轻瘫诊断中,核素显像、胃电图检测结果与临床综合诊断结果之间呈高度一致(Kappa值分别为0.851,0.839),钡餐造影诊断结果与临床综合诊断结果之间呈中度一致(Kappa=0.654)。结论糖尿病胃轻瘫患者与糖尿病功能性消化不良患者的胃电图中胃肌电活动存在明显差异,胃电图对糖尿病胃轻瘫具有良好的诊断价值,其对糖尿病胃轻瘫诊断灵敏度、准确性与核素显像一致。
Objective To investigate the diagnostic value of electrogastrogram(EGG) in diabetic gastroparesis by analyzing the results of EGG in patients with diabetic gastroparesis and diabetic functional dyspepsia. Methods From June 2019 to June 2021, 60 patients with diabetic gastroparesis(observation group) and 60 diabetic patients with functional dyspepsia(control group) in Nanjing Jiangbei Hospital were selected as the research subjects. All patients received fasting and postprandial examination of body surface EGG, X-ray barium meal and radionuclide imaging. The results of EGG were compared between the two groups. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of barium meal radiography, radionuclide imaging and EGG in patients with diabetic gastroparesis were compared. The consistency of the diagnosis of barium meal radiography, radionuclide imaging, EGG and clinical comprehensive diagnosis in the diagnosis of diabetic gastroparesis was analyzed. Results In the detection of EGG, the postprandial/postprandial power ratio and the percentage of bradycardia in the observation group were significantly higher than those in the control group(P<0.01), and the waveform response areas before and after meals in the observation group were significantly larger than those in the control group(P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of radionuclide imaging and EGG in the diagnosis of diabetic gastroparesis were significantly higher than those of barium meal radiography(P<0.01,P<0.05). However, there was no significant difference between radionuclide imaging and EGG(P>0.05). According to conformance analysis, the consistency between the results of radionuclide imaging and EGG in the diagnosis of diabetic gastroparesis were high(kappa=0.851, 0.839 respectively), and the results of barium meal examination were in a moderate agreement with that of clinical diagnosis(kappa=0.654). Conclusion There is a significant difference in gastric EGG activity between patients with diabetic gastroparesis and diabetic functional dyspepsia. EGG has a good diagnostic value for diabetic gastroparesis, and it can be used in the diagnosis of diabetic gastroparesis.
作者
刘冠岐
董国玉
丁婷婷
侯晓婷
黄晓丽
葛建新
王国品
LIU Guan-qi;DONG Guo-yu;DING Ting-ting;HOU Xiao-ting;HUANG Xiao-li;GE Jian-xin;WANG Guo-pin(Department of Gastroenterology,Nanjing Jiangbei Hospital Affiliated to Nantong University,Nanjing,Jiangsu 210048,China)
出处
《中国临床研究》
CAS
2021年第12期1662-1664,1669,共4页
Chinese Journal of Clinical Research
关键词
糖尿病
胃轻瘫
功能性消化不良
胃电图
核素显像
上消化道造影
Diabetes
Gastroparesis
Functional dyspepsia
Electrogastrogram
Radionuclide imaging
Upper gastrointestinal radiography
