Argon Murat, Duygun Ulkem, Daglioz Gozde, Omür Ozgur, Demir Esen, Aydogdu Sema
Department of Nuclear Medicine, Ege University Medical Faculty, Izmir, Bornova, Turkey.
Clin Nucl Med. 2006 May;31(5):262-5. doi: 10.1097/01.rlu.0000210500.64440.76.
The aim of our study was to evaluate the relationship between gastric emptying and gastroesophageal reflux (GER) in infants and children.
One hundred eight patients (pts) between 3 months and 5 years of age (77 boys, 31 girls) with clinical suspicion of GER disease were included in the study. Patients were divided into 2 groups according to the age range: group A, 0-2 years (57 pts), and group B, 2-5 (51 pts) years. Each group was divided into 2 subgroups according to the scintigraphic study as GER-positive and -negative. Cow's milk with Tc-99m sulfur colloid as radiotracer was used. Gastric emptying was expressed as the half emptying time (T1/2). The detection of activity in the esophagus at any time during scintigraphy was considered an indicator of GER episodes. Reflux episodes were graded as grade 1 if activity was detected on one or 2 frames and grade 2 if activity was detected on more than 2 frames.
Forty of the 108 patients (37%) had GER findings on scintigraphy. The comparison of gastric emptying time between positive GER scintigraphy and negative GER scintigraphy groups was not statistically significant in any age group. No association was found between age and rate of gastric emptying time. Although the comparison of T1/2 between grade 1 patients and the GER-negative group was not statistically significant, grade 2 patients showed significant differences and had prolonged gastric emptying times. Mild statistical correlation between the number of reflux episodes and gastric emptying half time was found.
As a conclusion, the relation between gastroesophageal reflux and delayed gastric emptying cannot be ignored. Our results support delayed gastric emptying to be a pathogenetic factor in gastroesophageal reflux in infants and children.
本研究旨在评估婴幼儿及儿童胃排空与胃食管反流(GER)之间的关系。
本研究纳入了108例年龄在3个月至5岁之间(77例男孩,31例女孩)临床怀疑患有GER疾病的患者。根据年龄范围将患者分为2组:A组,0至2岁(57例);B组,2至5岁(51例)。每组根据闪烁扫描结果分为GER阳性和阴性2个亚组。使用添加了锝-99m硫胶体作为放射性示踪剂的牛奶。胃排空以半排空时间(T1/2)表示。闪烁扫描过程中任何时间食管内活性的检测被视为GER发作的指标。如果在1帧或2帧上检测到活性,则反流发作分级为1级;如果在超过2帧上检测到活性,则分级为2级。
108例患者中有40例(37%)闪烁扫描显示有GER表现。在任何年龄组中,GER闪烁扫描阳性组与阴性组之间的胃排空时间比较均无统计学意义。未发现年龄与胃排空时间速率之间存在关联。虽然1级患者与GER阴性组之间的T1/2比较无统计学意义,但2级患者显示出显著差异且胃排空时间延长。发现反流发作次数与胃排空半衰期之间存在轻度统计学相关性。
总之,胃食管反流与胃排空延迟之间的关系不容忽视。我们的结果支持胃排空延迟是婴幼儿及儿童胃食管反流的一个致病因素。