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[用于测量固体试验餐胃排空的非侵入性13C辛酸呼气试验——与糖尿病患者闪烁扫描法的相关性及健康受试者的可重复性]

[Non-invasive 13C octanoic acid breath test for measuring stomach emptying of a solid test meal--correlation with scintigraphy in diabetic patients and reproducibility in healthy probands].

作者信息

Pfaffenbach B, Wegener M, Adamek R J, Wissuwa H, Schaffstein J, Aygen S, Hennemann O

机构信息

Medizinische Klinik, Ruhr-Universität Bochum, St. Josef-Hospital.

出版信息

Z Gastroenterol. 1995 Mar;33(3):141-5.

PMID:7754644
Abstract

The recently developed 13C-octanoic acid breath test allows the measurement of gastric emptying of solids. In this prospective study we wanted to investigate, whether the 13C-octanoic acid breath test using breath samples every half an hour is suitable in assessing gastric emptying in comparison to scintigraphy in diabetics. Furthermore, we examined the intraindividual reproducibility in healthy volunteers. 20 consecutive diabetics with clinical symptoms of gastroparesis received a solid double-labeled standard test meal. The meal consisted of 1 scrambled egg, labeled with 75 mg 13C-octanoic acid and 0.5 mCi 99mTc colloid, 50 g rye bread, 20 g butter, 200 ml orange juice; 280 kcal. Breath samples were taken at half hour intervals for 4 hours and analyzed for 13CO2 by isotope ratio mass spectrometry. Using a regression method gastric emptying half times (t 1/2) were determined and correlations to simultaneous 99mTc-scintigraphy were calculated. There was a moderate significant correlation of 13C-octanoic acid breath test t 1/2 and scintigraphic t 1/2 (R = 0.6; p = 0.008). The 13C-octanoic acid breath test t 1/2 obtained in 20 healthy volunteers measured at two separate days showed a coefficient of variation (VC), that was greater between subjects (VK = 42%) than between two measurements in the same subject (VK = 24%), which reflects a moderate intraindividual reproducibility. Taking breath samples every half an hour the 13C-octanoic acid breath test only reveals a moderate intraindividual reproducibility and a moderate correlation to scintigraphy in diabetics. For detailed assessment of solid gastric emptying in diabetics a 13C-octanoic acid breath test using shorter breath sampling intervals is recommended.

摘要

最近开发的13C-辛酸呼气试验可用于测量固体食物的胃排空情况。在这项前瞻性研究中,我们想探究每半小时采集一次呼气样本的13C-辛酸呼气试验与闪烁扫描法相比,是否适用于评估糖尿病患者的胃排空情况。此外,我们还检测了健康志愿者的个体内重复性。20例有胃轻瘫临床症状的连续糖尿病患者接受了固体双标记标准试验餐。该餐包括1个用75毫克13C-辛酸和0.5毫居里99mTc胶体标记的炒鸡蛋、50克黑麦面包、20克黄油、200毫升橙汁;共280千卡热量。每隔半小时采集呼气样本,持续4小时,并通过同位素比率质谱法分析其中的13CO2。采用回归方法确定胃排空半衰期(t 1/2),并计算其与同步进行的99mTc闪烁扫描法的相关性。13C-辛酸呼气试验的t 1/2与闪烁扫描法的t 1/2之间存在中度显著相关性(R = 0.6;p = 0.008)。在20名健康志愿者中,于两个不同日期测量得到的13C-辛酸呼气试验t 1/2的变异系数(VC)显示,受试者之间的变异系数(VK = 42%)大于同一受试者两次测量之间的变异系数(VK = 24%),这反映出个体内重复性为中度。每半小时采集一次呼气样本时,13C-辛酸呼气试验在糖尿病患者中仅显示出中度的个体内重复性以及与闪烁扫描法的中度相关性。对于详细评估糖尿病患者的固体胃排空情况,建议采用更短呼气采样间隔的13C-辛酸呼气试验。

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