Feldman M, Smith H J, Simon T R
Gastroenterology. 1984 Oct;87(4):895-902.
The purpose of these studies was to develop a radiologic method for assessing gastric emptying of an indigestible solid in humans and to apply this technique to the evaluation of patients with diabetes mellitus. Thirty healthy subjects ingested 10 solid radiopaque markers (small pieces of nasogastric tubing) together with a standard meal (donuts and 7-Up). Radiographs of the upper abdomen were obtained hourly for up to 6 h until all markers had emptied from the stomach. Although most of the liquid component of the meal, labeled with 111In, emptied during the first hour (as assessed simultaneously by radionuclide scintigraphy), few radiopaque markers emptied from the stomach during the first 2 h after the meal. Most markers emptied during the fourth postprandial hour, and all 10 markers had emptied by 6 h in 45 of 46 experiments. In contrast, not all of the solid radiopaque markers emptied from the stomach by 6 h in 16 of 26 experiments in patients with diabetes mellitus (p less than 0.001 vs. healthy controls). In some experiments, 99mTc-labeled scrambled eggs were added to the meal so that emptying of this digestible solid, assessed by scintigraphy, could be compared with emptying of liquids and solid radiopaque markers. In healthy subjects, the digestible solid emptied more slowly than the liquid (t 1/2 = 154 +/- 11 min vs. 30 +/- 3 min, p less than 0.001), but emptying of digestible solid was significantly faster than the emptying of the indigestible solid radiopaque markers. In diabetics, emptying rates for the digestible solid and liquid were close to normal (t 1/2 = 178 +/- 5 min and 40 +/- 3 min, respectively), whereas indigestible solid markers were retained in the stomach 6 h after the meal in 50% of the patients. Radiopaque markers proved to be a simple method for measuring gastric emptying of indigestible solids in humans. Using this technique, patients with insulin-dependent diabetes mellitus had a high incidence of abnormally slow gastric emptying of indigestible solids; the method may be a more sensitive indicator of gastric motor dysfunction than radionuclide scintigraphy.
这些研究的目的是开发一种用于评估人体中难消化固体胃排空情况的放射学方法，并将该技术应用于糖尿病患者的评估。30名健康受试者与一顿标准餐（甜甜圈和七喜汽水）一起摄入了10个不透射线的固体标志物（小段鼻胃管）。每小时获取上腹部的X光片，持续6小时，直到所有标志物都从胃中排空。尽管餐食中大部分用铟-111标记的液体成分在第一小时内排空（通过放射性核素闪烁扫描同时评估），但在餐后的前2小时内，很少有不透射线的标志物从胃中排空。大多数标志物在餐后第四小时排空，在46项实验中的45项中，所有10个标志物在6小时内都已排空。相比之下，在26项糖尿病患者的实验中，有16项实验中并非所有不透射线的固体标志物在6小时内都从胃中排空（与健康对照组相比，p<0.001）。在一些实验中，将99mTc标记的炒鸡蛋添加到餐食中，以便通过闪烁扫描评估这种易消化固体的排空情况，并与液体和不透射线固体标志物的排空情况进行比较。在健康受试者中，易消化固体的排空比液体慢（t1/2 = 154±11分钟对30±3分钟，p<0.001），但易消化固体的排空明显快于难消化不透射线固体标志物的排空。在糖尿病患者中，易消化固体和液体的排空率接近正常（分别为t1/2 = 178±5分钟和40±3分钟），而在50%的患者中，难消化固体标志物在餐后6小时仍留在胃中。不透射线标志物被证明是一种测量人体中难消化固体胃排空的简单方法。使用该技术，胰岛素依赖型糖尿病患者难消化固体胃排空异常缓慢的发生率很高；该方法可能是比放射性核素闪烁扫描更敏感的胃运动功能障碍指标。
