Lipp R W, Schnedl W J, Hammer H F, Kotanko P, Leb G, Krejs G J
Department of Internal Medicine, Karl-Franzens-University, Graz, Austria.
J Nucl Med. 1997 May;38(5):814-8.
This study investigated the prevalence of accelerated gastric emptying in 40 consecutive nonselected patients with longstanding insulin-dependent diabetes mellitus (range 11-54 yr; mean 27 yr).
The gastric emptying of a semisolid meal labeled with 99mTc was continuously recorded with a dual-head gamma camera for 90 min in patients who were supine.
Eleven patients demonstrated delayed gastric emptying, but three male diabetics showed accelerated gastric emptying with retention values that were different from controls already after 10 min of recording (89% +/- 3% versus 96% +/- 4%; p < 0.02). During the 90-min segment, accelerated gastric emptying reduced initial gastric contents to 11% +/- 8% (p < 0.001) as compared to 50% +/- 10% in control subjects and 78% +/- 6% (p < 0.001) in patients with delayed gastric emptyings. Accelerated gastric emptying was characterized by an almost equal initial meal distribution in proximal and distal compartments of stomach, both emptying approximately 90% of their contents within 90 min. Normal and delayed gastric emptying was characterized by a 60%-40% initial ratio of meal distribution between gastric compartments. During normal emptying, both compartments reduced contents with approximately 50%, but delayed gastric emptying was caused by only a 15% reduction of proximal contents accompanied by a 34% reduction in distal contents.
Recording in the supine position to abolish gravitational influences demonstrated accelerated gastric emptying of a firm semisolid meal with a prevalence of 8%. However, delayed gastric emptying was shown as the predominant gastric manifestation of longstanding insulin-dependent diabetes mellitus with a prevalence of 28%.
本研究调查了40例未经挑选的长期胰岛素依赖型糖尿病患者（病程11 - 54年；平均27年）中胃排空加速的患病率。
对40例患者在仰卧位时用双头γ相机连续记录99mTc标记的半固体餐的胃排空情况，记录时间为90分钟。
11例患者表现为胃排空延迟，但3例男性糖尿病患者出现胃排空加速，记录10分钟后其潴留值就与对照组不同（89%±3%对96%±4%；p<0.02）。在90分钟时间段内，胃排空加速使初始胃内容物减少至11%±8%（p<0.001），而对照组为50%±10%，胃排空延迟的患者为78%±6%（p<0.001）。胃排空加速的特点是初始餐在胃的近端和远端区域分布几乎相等，两者在90分钟内排空其内容物的约90%。正常和延迟胃排空的特点是餐在胃各区域的初始分布比例为60%-40%。在正常排空过程中，两个区域的内容物均减少约50%，但胃排空延迟是由于近端内容物仅减少15%，同时远端内容物减少34%所致。
在仰卧位记录以消除重力影响显示，固体半固体餐胃排空加速的患病率为8%。然而，胃排空延迟是长期胰岛素依赖型糖尿病的主要胃部表现，患病率为28%。
