Stotzer P O, Abrahamsson H
Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Neurogastroenterol Motil. 2000 Oct;12(5):415-9. doi: 10.1046/j.1365-2982.2000.00218.x.
According to animal experiments, postprandial gastric emptying of indigestible solids is mainly related to the antral phase III activity of the migrating motor complex. Gastric emptying of indigestible solids in humans has not been directly correlated to pressure recordings. The aim of the present study was to investigate the postprandial emptying pattern of indigestible solids in humans and its relation to fed and fasted antral motility. Ten healthy volunteers participated. After an overnight fast they had a standard breakfast. Two sizes of radiopaque markers (ROMs) were given with the test meal; ten cubes each of side measurement 1.5 mm and 3 mm, respectively. Emptying of the ROMs from the stomach was followed by fluoroscopy with simultaneous antral manometry. In six of the subjects, fasting antral manometry was performed on one day and on another day, the emptying of 7 mm cylindrical particles together with 3 mm cubes, in the absence of a gastric tube was recorded. All ROMs were emptied within 5 h (range 1.5-4.5 h). In all subjects, the smaller particles (1.5 mm) showed a slight, insignificant tendency to move from the stomach more rapidly than the larger (3 mm) particles. None of the subjects had an antral phase III before all ROMs were emptied from the stomach. Instead, the typical irregular postprandial pressure activity was present in all subjects until the emptying was completed. Furthermore, the highest postprandial motility index during the emptying study was far below the motility index during phase III, but comparable to the motility index during late phase II. Emptying of the 7 mm particles occurred significantly more slowly at 1.5-2.5 h, but otherwise was similar to the emptying of the smaller particles. There was no difference between emptying of the 3 mm cubes with or without the presence of the tube. Contrary to common opinion, gastric emptying of indigestible solids after a meal can occur unrelated to the antral phase III, at least up to a particle size of 3 mm and perhaps even 7 mm. These findings are of great importance for the evaluation of gastric emptying of indigestible solids, including the pharmacodynamics of orally administered drugs.
根据动物实验，餐后难消化固体的胃排空主要与移行性运动复合波的胃窦Ⅲ期活动有关。人类难消化固体的胃排空与压力记录未直接相关。本研究的目的是调查人类餐后难消化固体的排空模式及其与进食和禁食时胃窦运动的关系。10名健康志愿者参与了研究。经过一夜禁食后，他们食用了标准早餐。测试餐中加入了两种尺寸的不透X线标志物（ROMs）；分别为边长1.5毫米和3毫米的10个立方体。通过荧光透视同时进行胃窦测压来跟踪ROMs从胃中的排空情况。在6名受试者中，一天进行了禁食时的胃窦测压，另一天在没有胃管的情况下记录了7毫米圆柱形颗粒与3毫米立方体的排空情况。所有ROMs均在5小时内排空（范围为1.5 - 4.5小时）。在所有受试者中，较小颗粒（1.5毫米）比较大颗粒（3毫米）从胃中移动得稍快，但差异不显著。在所有ROMs从胃中排空之前，没有受试者出现胃窦Ⅲ期。相反，在排空完成之前，所有受试者均出现典型的餐后不规则压力活动。此外，排空研究期间餐后最高运动指数远低于Ⅲ期的运动指数，但与Ⅱ期后期的运动指数相当。7毫米颗粒在1.5 - 2.5小时的排空明显更慢，但在其他方面与较小颗粒的排空相似。有或没有胃管时，3毫米立方体的排空没有差异。与普遍观点相反，餐后难消化固体的胃排空可能与胃窦Ⅲ期无关，至少对于粒径为3毫米甚至可能7毫米的颗粒是这样。这些发现对于评估难消化固体的胃排空，包括口服药物的药效学具有重要意义。
