McCallum R W, Berkowitz D M, Lerner E
Gastroenterology. 1981 Feb;80(2):285-91.
Delayed gastric emptying of liquids and/or solids was hypothesized as a mechanism which could increase the volume of gastroduodenal contents and could contribute to the pathogenesis of gastroesophageal reflux. Gastric emptying of an isotope-labeled mixed solid-liquid meal was compared in a study of 20 age-matched gastroesophageal reflux patients and 20 normal subjects whose sex distribution and weight were similar; and also in a study of 100 reflux patients and 26 normals. The 20 GER patients emptied isotope from the stomach at a slower rate than age-matched normals at 30 min (p < 0.10); 60 min (p < 0.05, one-tailed t-test); and 90 min (p < 0.05). Using the range established from 26 normal subjects for percent of isotope remaining in the stomach after 90 min (mean +/- 2 SD), 53% of the 100 reflux patients evaluated were within the "normal" range of the controls; 41% had delayed gastric emptying exceeding the upper limit of isotope retention; and 6% emptied isotope rapidly. The means for LES pressure, age, and weight among the slow and "normal" emptying reflux esophagitis patients were similar. Based on the composition of the test meal, it is hypothesized that motor functions of the stomach may be abnormal in a high percentage (41%) of GER patients. The results also suggest a rationale for employing agents which enhance gastric emptying in the therapeutic approach to gastroesophageal reflux.
液体和/或固体的胃排空延迟被认为是一种可能增加胃十二指肠内容物体积并导致胃食管反流发病机制的机制。在一项研究中，对20名年龄匹配、性别分布和体重相似的胃食管反流患者以及20名正常受试者进行了比较，观察同位素标记的混合固体-液体餐的胃排空情况；还对100名反流患者和26名正常人进行了研究。20名胃食管反流患者在30分钟时胃内同位素排空速度比年龄匹配的正常人慢（p < 0.10）；60分钟时（p < 0.05，单尾t检验）；90分钟时（p < 0.05）。根据26名正常受试者确定的90分钟后胃内剩余同位素百分比范围（平均值±2标准差），在评估的100名反流患者中，53%在对照组的“正常”范围内；41%的胃排空延迟超过同位素保留上限；6%的患者同位素排空迅速。胃排空缓慢和“正常”的反流性食管炎患者之间的LES压力、年龄和体重均值相似。基于试验餐的成分，推测在高比例（41%）的胃食管反流患者中胃的运动功能可能异常。结果还为在胃食管反流的治疗方法中使用增强胃排空的药物提供了理论依据。
