Chang Full-Young, Lu Ching-Liang, Chen Chih-Yen, Luo Jiing-Chyuan, Jium Kang Lih, Lee Shou-Dong
Division of Gastroenterology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
J Gastroenterol Hepatol. 2003 Nov;18(11):1250-6. doi: 10.1046/j.1440-1746.2003.03168.x.
It remains debatable if duodenal ulcer (DU) or Helicobacter pylori infection has a definite impact on human gastric emptying (GE). We explored the nature of water GE in active DU patients before and after ulcer healing and the influence of H. pylori eradication on GE.
A home made applied potential tomography (APT) was used to measure liquid GE. Twelve electrodes were placed in a circular array around the upper abdomen of studied subjects. After drinking 500 mL of ion-free water, paired electrodes injected electrical current and the remaining 10 electrodes recorded signals, one-by-one in a rotating order. Based on tomographical calculation, the serial changes of averaged signals from altered resistivities were constructed to display GE. Initially, 64 H. pylori infected active DU patients were enrolled. After APT measurement, one-week triple therapy (omeprazole, amoxicillin and clarithromycin) was dispensed. Patients were asked back to determine ulcer/H. pylori status and GE on a scheduled date 3 months later. Finally, 58 patients finished the trial with valid and readable GE data obtained.
The ulcer healing and H. pylori eradicated rates were 91.4% and 82.8%, respectively. In general, liquid GE was prolonged in all DU patients at follow up. Of 48 eradicated patients, 35.4% manifested either enhanced or delayed GE before treatment, whereas only five (10.4%) had abnormal GE after treatment (P < 0.0001). In contrast, this characteristically normalized GE was not found in non-eradicated patients.
Water GE of active DU patients ranges from enhanced to delayed, while an effective H. pylori triple therapy is useful not only for healing ulcers, but also for restoring abnormal GE.
十二指肠溃疡（DU）或幽门螺杆菌感染是否对人体胃排空（GE）有确切影响仍存在争议。我们探讨了活动期DU患者溃疡愈合前后水胃排空的本质以及幽门螺杆菌根除对胃排空的影响。
使用自制的应用电位断层扫描（APT）来测量液体胃排空。在研究对象的上腹部周围以圆形阵列放置12个电极。饮用500 mL无离子水后，成对电极注入电流，其余10个电极按旋转顺序逐一记录信号。基于断层计算，构建来自电阻率变化的平均信号的系列变化以显示胃排空。最初，纳入64例幽门螺杆菌感染的活动期DU患者。在进行APT测量后，给予为期一周的三联疗法（奥美拉唑、阿莫西林和克拉霉素）。要求患者在3个月后的预定日期返回以确定溃疡/幽门螺杆菌状态和胃排空情况。最后，58例患者完成试验并获得了有效且可读的胃排空数据。
溃疡愈合率和幽门螺杆菌根除率分别为91.4%和82.8%。总体而言，所有DU患者在随访时液体胃排空均延长。在48例根除幽门螺杆菌的患者中，35.4%在治疗前表现为胃排空增强或延迟，而治疗后只有5例（10.4%）胃排空异常（P<0.0001）。相比之下，未根除幽门螺杆菌的患者未发现这种胃排空特征性恢复正常的情况。
活动期DU患者的水胃排空范围从增强到延迟，而有效的幽门螺杆菌三联疗法不仅有助于溃疡愈合，还能恢复异常的胃排空。
