Knight L C, Parkman H P, Brown K L, Miller M A, Trate D M, Maurer A H, Fisher R S
Department of Diagnostic Imaging, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Am J Gastroenterol. 1997 Jun;92(6):968-75.
The effects of gender on gastric emptying have not been fully elucidated. The aims of this study were to determine how gender affects gastric emptying and to see whether any of the observed differences in gastric emptying correlate with alterations in antral motility as measured by dynamic antral scintigraphy (DAS), cutaneous electrogastrography (EGG), and antroduodenal manometry (ADM).
Nine normal women [age 27.9 +/- 2.2 (mean +/- SEM) yr] in the first 10 days of the menstrual cycle and 13 normal men (age 27.5 +/- 1.7 yr) underwent simultaneous gastric emptying scintigraphy, DAS, EGG, and ADM. After an overnight fast and placement of an ADM catheter and EGG electrodes, a 60-min fasting recording was obtained, followed by ingestion of a 99m Tc-labeled solid meal. Measurements for all modalities were acquired every 10-15 min for 180 min.
The gastric T1/2 was longer in women than in men [102 +/- 18 min vs. 71 +/- 4 (mean +/- SEM) min, p < 0.05]. A comparison of the gastric emptying pattern in women with that in men revealed no difference in proximal gastric emptying and lag phase, but in women the terminal slope of emptying was decreased compared with that in men (p < 0.05). The contractility measured in mid-antrum by DAS was significantly lower for women (p < 0.05). A decrease was also seen in the strength of contractions as measured by ADM.
These data demonstrate that gastric emptying of solid food in normal young, premenopausal women is slower than in age-matched men, even during the first 10 days of the menstrual cycle. The findings suggest that the delay is due primarily to altered distal gastric motor function. This hypothesis was corroborated by finding decreased antral contractility as recorded by both dynamic antral scintigraphy and ADM. This study demonstrates the need to use appropriate control values to evaluate symptomatic female patients.
性别对胃排空的影响尚未完全阐明。本研究的目的是确定性别如何影响胃排空,并观察胃排空中观察到的任何差异是否与通过动态胃窦闪烁扫描(DAS)、皮肤胃电图(EGG)和胃十二指肠测压(ADM)测量的胃窦运动改变相关。
9名处于月经周期前10天的正常女性[年龄27.9±2.2(均值±标准误)岁]和13名正常男性(年龄27.5±1.7岁)同时接受胃排空闪烁扫描、DAS、EGG和ADM检查。在禁食过夜并放置ADM导管和EGG电极后,进行60分钟的禁食记录,随后摄入一顿99m锝标记的固体餐。所有检查项目每10 - 15分钟测量一次,共测量180分钟。
女性的胃半排空时间长于男性[102±18分钟对71±4(均值±标准误)分钟,p < 0.05]。比较女性和男性的胃排空模式发现,近端胃排空和延迟期无差异,但女性的排空终末斜率低于男性(p < 0.05)。通过DAS测量的胃窦中部收缩力女性显著较低(p < 0.05)。ADM测量的收缩强度也有所降低。
这些数据表明,正常年轻、未绝经女性的固体食物胃排空比年龄匹配的男性慢,即使在月经周期的前10天也是如此。研究结果表明,延迟主要是由于远端胃运动功能改变。动态胃窦闪烁扫描和ADM记录的胃窦收缩力降低证实了这一假设。本研究表明,评估有症状的女性患者需要使用适当的对照值。