Otte Johannes A, Huisman Ad B, Geelkerken Robert H, Kolkman Jeroen J
Department of Internal Medicine and Gastroenterology, Medisch Spectrum Twente, Enschede, The Netherlands.
Eur J Gastroenterol Hepatol. 2008 Jan;20(1):62-7. doi: 10.1097/MEG.0b013e3282ef633a.
In most patients with chronic splanchnic syndrome the celiac artery is involved, enabling the use of gastric exercise tonometry as a diagnostic function test. In this study, we investigated the feasibility of combining gastric and jejunal exercise tonometry and determined the normal values. We investigated the potential diagnostic value of combining gastric with jejunal exercise tonometry.
Between 1998 and 2000, combined gastric and jejunal exercise tonometry tests were performed in a healthy volunteer and in patients suspected of chronic gastrointestinal ischemia. Using automated air tonometry, gastric (PgCO2) and jejunal PCO2 (PjCO2) were measured before, during and after 10-min of exercise. Luminal-arterial PCO2 gradients (DeltagPCO2 respectively DeltajPCO2) were calculated. In the patient cohort, final diagnosis of chronic ischemia was made by our institutional multidisciplinary working group on gastrointestinal ischemia.
Jejunal tonometry was possible in 25 of 27 participants. The healthy volunteer was tested twice, yielding a total of 26 combined tests. Mean normal basal PjCO2 was 0.9 kPa higher than PgCO2. The calculated upper threshold (mean+2SD) of normal DeltajPCO2 was 1.4 kPa. In five of eight patients with chronic gastrointestinal ischemia gastric exercise tonometry was abnormal, in one, both gastric and jejunal tonometry were abnormal, in two only jejunal exercise tonometry was abnormal.
Combined gastric and jejunal exercise tonometry is a feasible procedure that is relatively easy to perform. On the basis of this pilot study, jejunal tonometry seems to have a small additional value in the diagnosis of chronic gastrointestinal ischemia.
在大多数慢性内脏综合征患者中，腹腔动脉受累，这使得胃运动张力测定法可作为一种诊断功能测试。在本研究中，我们探讨了联合应用胃和空肠运动张力测定法的可行性并确定其正常值。我们还研究了联合应用胃和空肠运动张力测定法的潜在诊断价值。
1998年至2000年期间，对一名健康志愿者和疑似慢性胃肠道缺血的患者进行了联合胃和空肠运动张力测定试验。使用自动气测法，在运动前、运动期间和运动10分钟后测量胃内二氧化碳分压（PgCO2）和空肠二氧化碳分压（PjCO2）。计算管腔-动脉二氧化碳分压梯度（分别为DeltagPCO2和DeltajPCO2）。在患者队列中，慢性缺血的最终诊断由我们机构的胃肠道缺血多学科工作组做出。
27名参与者中有25名成功进行了空肠张力测定。对健康志愿者进行了两次测试，共进行了26次联合测试。正常基础PjCO2的平均值比PgCO2高0.9 kPa。正常DeltajPCO2的计算上限（平均值+2标准差）为1.4 kPa。在8例慢性胃肠道缺血患者中，5例胃运动张力测定异常，1例胃和空肠张力测定均异常，2例仅空肠运动张力测定异常。
联合胃和空肠运动张力测定是一种可行的方法，相对容易实施。基于这项初步研究，空肠张力测定在慢性胃肠道缺血的诊断中似乎具有较小的附加价值。
