Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
Neurogastroenterol Motil. 2010 Dec;22(12):1298-302, e338. doi: 10.1111/j.1365-2982.2010.01584.x. Epub 2010 Aug 19.
Cyclic vomiting syndrome (CVS) in adults is a disorder characterized by recurrent and stereotypic episodes of severe nausea, vomiting and abdominal pain separated by symptom-free intervals. Both rapid and delayed gastric emptying (GE) have been observed but the reports involved small numbers of CVS patients.
We performed a retrospective study of 92 adult patients who met Rome Ш diagnostic criteria for CVS between 2003 and 2009 at the Kansas University Medical Center. Gastric emptying was measured by a standardized scintigraphic method involving a low fat (2%) isotope labeled egg white meal of 250 Kcal, with anterior and posterior gastric imaging in the standing position obtained at 0, 1, 2, 4 h after meal ingestion. Rapid GE was defined as <50% isotope retention at 1st h and/or <30% at 2nd h and delayed GE as >10% at 4 h.
Ninety two patients were analyzed: 47 males and 45 females mean of age 37 ± 12 years (range: 20-68 years). There were 27 patients with a personal history of migraine headache, 30 with history of marijuana use, 12 had diabetes mellitus (DM) and 10 had irritable bowel syndrome (IBS) as an accompanying diagnosis. Fifty four patients (59%) met criteria for rapid GE, 25 (27%) had normal GE and 13 (14%) had slow GE. Eighty percent of patients with co-existing IBS symptoms were identified as rapid. The subset with delayed emptying was often associated with narcotics use, DM and marijuana use (P < 0.05).
CONCLUSIONS & INFERENCES: (i) In adult CVS patients, GE is generally either rapid or normal. (ii) Cyclic vomiting syndrome is an important new etiology to explain the finding of rapid GE on a radionuclide test. (iii) The small subset of CVS patients (14%) whose GE was slow were explained by the role of narcotics and/or marijuana.
成人周期性呕吐综合征（CVS）是一种以反复发作和刻板的严重恶心、呕吐和腹痛为特征的疾病，这些症状之间有无症状间歇期。快速和延迟胃排空（GE）都有观察到，但报告涉及的 CVS 患者人数较少。
我们对 2003 年至 2009 年间在堪萨斯大学医学中心符合罗马Ш CVS 诊断标准的 92 名成年患者进行了回顾性研究。通过一种标准化闪烁扫描方法测量胃排空，该方法使用低脂肪（2%）同位素标记的 250 卡路里蛋清餐，在餐后 0、1、2、4 小时在站立位获得前后胃成像。快速 GE 定义为第 1 小时同位素保留<50%，和/或第 2 小时<30%；延迟 GE 定义为第 4 小时>10%。
分析了 92 名患者：47 名男性和 45 名女性，平均年龄 37 ± 12 岁（范围：20-68 岁）。27 名患者有偏头痛病史，30 名患者有大麻使用史，12 名患者患有糖尿病（DM），10 名患者患有肠易激综合征（IBS）作为伴随诊断。54 名患者（59%）符合快速 GE 标准，25 名患者（27%）GE 正常，13 名患者（14%）GE 缓慢。80%的伴有 IBS 症状的患者被确定为快速 GE。排空延迟的亚组常与使用麻醉剂、DM 和大麻有关（P < 0.05）。
（i）在成人 CVS 患者中，GE 通常是快速或正常的。（ii）周期性呕吐综合征是放射性核素检查中快速 GE 的一个重要新病因。（iii）GE 缓慢的 CVS 患者（14%）亚组的原因是麻醉剂和/或大麻的作用。
