上腹部不定愁訴患者の胃･胆嚢運動に関する研究

現在,上腹部不定愁訴の原因は特定されていない｡その原因を解明するため,上腹部不定愁訴患者8人と健常対照者10人に対して液体食の胃排出能と,食事負荷による胆嚢収縮能を測定した｡胃排出時間,胆嚢収縮能はいずれも両者に有意な差は認められなかった｡健常対照者では胃排出時間と胆嚢収縮時間に有意な相関関係が認められたが,上腹部不定愁訴群では相関関係は認められなかった｡上腹部不定愁訴の原因として胃･胆嚢協調運動障害の存在が示唆 された。

Subjective symptoms are quite similar between cystic duct syndrome (CDS) and non-ulcer dyspepsia (NUD) : epigastralgia, hypochondralgia and vague complaints in the upper part of the abdomen. Recently, there has been several reports suggesting that the cause of these disorders is postprandial dysmotility in the gallbladder and stomach. However, there has been no report suggesting incoordination of postprandial gastrobilialy motility as the cause of tha above mentioned complaints in these disorders. The aim of this study was to define the difference of postprandial gastrobiliary motility between patients with NUD and controls. Eight patients with NUD and 10 controls were studied. Gastric emptying time of liquid meal and gallbladder contraction were measured, simultaneously. There was no significant difference between study patients and controls when gastric emptying time and gallbladder contraction rate were compared in isolation. However, when these two parameters were assessed in combination, gastric emptying time was linearly correlated with minimum ballbladder contraction time in controls but not in patients. We conclude that the incoordination between gastric emptying and minimal gallbladder contraction may be one of the major causes of the symptoms in NUD.