Machado Rodrigo Strehl, Reber Marialice, Patrício Francy Reis da Silva, Kawakami Elisabete
Department of Pediatric Gastroenterology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
J Pediatr Gastroenterol Nutr. 2008 Apr;46(4):403-8. doi: 10.1097/MPG.0b013e318159224e.
To evaluate gastric emptying of solids in children and adolescents with functional dyspepsia with and without Helicobacter pylori infection.
The study included 27 female patients (mean age 13.38 +/- 2.81 y) with functional dyspepsia according to Rome II criteria who were selected after upper gastrointestinal endoscopy found no major mucosal abnormality. Fragments were collected from the esophagus, gastric antrum, and gastric body for histological examination and rapid urease test. H. pylori infection was diagnosed according to the rapid urease test and histological appearance. The histological appearance of the gastric mucosa was evaluated according to modified Sydney criteria. A C-octanoic breath test was performed after a test meal (2 slices of toasted bread, 10 g margarine, and 1 egg with 100 microL of the tracer dipped in the yolk) with 13 points of air collection in 4 hours.
Infection with H. pylori was observed in 12 of 27 patients (44.4%). The gastric emptying half-time was shorter in infected patients than in uninfected patients (mean +/- SD 153.4 +/- 20.0 min vs 179.2 +/- 32.2 min; P = 0.019), as was the lag phase (106.3 +/- 22.6 vs 126.6 +/- 22.7 min; P = 0.038). There was no relationship between gastric emptying (half-time and lag phase) and degree of histological abnormality. Vomiting and nausea were associated with slower gastric emptying in patients without H. pylori gastritis more often than in infected patients.
The study suggests that delayed gastric emptying can play an important role in a subgroup of dyspeptic patients, particularly those without H. pylori infection who have nausea and vomiting.
评估有无幽门螺杆菌感染的功能性消化不良儿童及青少年的固体胃排空情况。
本研究纳入了27例符合罗马II标准的功能性消化不良女性患者（平均年龄13.38±2.81岁），这些患者经上消化道内镜检查未发现明显黏膜异常。从食管、胃窦和胃体取组织碎片进行组织学检查及快速尿素酶试验。根据快速尿素酶试验及组织学表现诊断幽门螺杆菌感染。根据改良悉尼标准评估胃黏膜的组织学表现。在进食试验餐（2片烤面包、10克人造黄油和1个蘸有100微升示踪剂蛋黄的鸡蛋）后进行C-辛酸呼气试验，4小时内采集13次气体样本。
27例患者中有12例（44.4%）观察到幽门螺杆菌感染。感染患者的胃排空半衰期短于未感染患者（平均±标准差153.4±20.0分钟对179.2±32.2分钟；P = 0.019），延迟期也较短（106.3±22.6对126.6±22.7分钟；P = 0.038）。胃排空（半衰期和延迟期）与组织学异常程度之间无相关性。与感染患者相比，无幽门螺杆菌胃炎的患者中，呕吐和恶心更常与胃排空减慢有关。
该研究表明，胃排空延迟在一部分消化不良患者中起重要作用，尤其是那些无幽门螺杆菌感染且有恶心和呕吐症状的患者。
