摘要:
Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P<0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P<0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P<0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P>0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.%目的 研究正常人胃电活动的时间和空间特征.方法 选择2016年1月1日至2月29日需行腹腔镜手术的非胃部病变患者,应用高分辨地形图(HRM)技术,在其手术前采集麻醉状态下的空腹胃电慢波信号,计算慢波参数,绘制胃电时间活化地图和速度矢量图等,得到胃不同部位的胃电活动时空特征.两组比较采用两独立样本t检验,多组间比较采用单因素方差分析.结果 正常胃电起搏区位于胃体中上段近大弯侧,胃体电活动沿胃长轴向胃窦传播,贲门和胃底部均未记录到慢波信号.胃各部位慢波频率一致,平均值为(2.61±0.11)周期/min.与胃体相比,胃电起搏区慢波波幅高[(4.19±0.73) mV比(1.67±0.89) mV]、波速快[(7.24±1.37) mm/s比(4.94±0.20) mm/s],差异均有统计学意义(t=18.89、4.95,P均<0.01).胃窦慢波波幅亦高于胃体[(3.21±0.49) mV比(1.67±0.89) mV],波速也较胃体快[(6.44±0.82) mm/s比(4.94±0.20) mm/s],差异均有统计学意义(t=4.85、4.95,P均<0.05);胃窦慢波波幅较胃电起搏区低[(3.21±0.49) mV比(4.19±0.73) mV],差异有统计学意义(t=-3.67,P<0.05),而波速比较[(6.44士0.82)mm/s比(7.24±1.37) mm/s]差异无统计学意义(P>0.05).结论 正常人胃电起搏区位于胃体中上段靠近大弯侧,产生慢波并主导全胃电节律.胃各个部位的慢波波幅和波速具有梯度性.HRM技术作为一种成熟、可靠的研究方法,可用于观察胃电活动的时空特征,为胃电异常的研究提供可能性.