Jian R, Ducrot F, Piedeloup C, Mary J Y, Najean Y, Bernier J J
Gut. 1985 Apr;26(4):352-8. doi: 10.1136/gut.26.4.352.
Symptoms suggesting gastroparesis in patients without gastric outlet obstruction are very common but their relation to an objective delay of gastric emptying has been poorly investigated. A dual isotopic technique was used to evaluate patients with non-obstructive dyspepsia (idiopathic and secondary) (part 1) and to assess the effects of a new gastrokinetic agent: cisapride, on gastric emptying in such patients (part 2). Sixty patients with postprandial dyspeptic symptoms (vomiting, nausea, gastric bloating or full feeling) and without lesions at upper endoscopy were studied. They were distributed into three groups: idiopathic dyspepsia (n = 31), postvagotomy dyspepsia (n = 16) and dyspepsia secondary to medical disorders (n = 13). All patients ingested the same ordinary meal; 99mTc sulphur colloid tagged egg white was the solid phase marker and 111In chloride was the liquid phase marker. In part 1, evaluation of gastric emptying in the first 50 patients shows a delay of gastric emptying rate of solids and liquids as compared with controls. Striking differences separate the three groups of patients, however, percentages of delayed gastric emptying rate of solids and or liquids averaged 90% in postvagotomy or secondary dyspepsia groups whereas it was 44% in idiopathic dyspepsia group. Moreover, liquid emptying rate was often the only one impaired in idiopathic dyspepsia, and in 12 of the 27 patients of this group the faster emptying rate of liquids as compared with that of solids (always found in normal subjects), could not be evidenced. In part 2, 10 patients entered a double blind cross over study of cisapride (8 mg intravenously). A significant increase of solid (p<0.01) and liquid (p<0.05) emptying rates was found in patients with initial gastric emptying delay. This study emphasises the importance of an objective evaluation of gastric emptying in the presence of symptoms of gastric stasis and suggests that specific local acting therapy may be useful in patients with identified abnormal gastric emptying.
在没有胃出口梗阻的患者中，提示胃轻瘫的症状非常常见，但它们与胃排空客观延迟之间的关系却鲜有研究。采用双同位素技术对非梗阻性消化不良（特发性和继发性）患者进行评估（第1部分），并评估一种新型促胃肠动力药：西沙必利，对此类患者胃排空的影响（第2部分）。研究了60例有餐后消化不良症状（呕吐、恶心、胃胀或饱腹感）且上消化道内镜检查无病变的患者。他们被分为三组：特发性消化不良（n = 31）、迷走神经切断术后消化不良（n = 16）和继发于内科疾病的消化不良（n = 13）。所有患者摄入相同的普通餐食；99mTc硫胶体标记的蛋清为固相标记物，111In氯化物为液相标记物。在第1部分中，对前50例患者胃排空的评估显示，与对照组相比，固体和液体的胃排空率均延迟。然而，三组患者之间存在显著差异，迷走神经切断术后或继发性消化不良组固体和/或液体胃排空率延迟的百分比平均为90%，而特发性消化不良组为44%。此外，液体排空率通常是特发性消化不良中唯一受损的指标，在该组27例患者中的12例中，与固体排空率相比（正常受试者中总是如此）液体排空更快的情况无法得到证实。在第2部分中，10例患者进入了西沙必利（8mg静脉注射）的双盲交叉研究。在初始胃排空延迟的患者中，固体（p<0.01）和液体（p<0.05）排空率显著增加。本研究强调了在存在胃潴留症状时对胃排空进行客观评估的重要性，并表明特定的局部作用疗法可能对已确定胃排空异常的患者有用。
