~(131)I抗AFP抗体-MMC双弹头导向治疗肝癌31例

目的观察化疗兼内照射的新型双弹头免疫导向治疗肝癌的疗效．方法以马抗人ＡＦＰ多克隆抗体（抗ＡＦＰＡｂ）和大鼠抗人ＡＦＰ单克隆抗体（抗ＡＦＰＭｃＡｂ）为载体，核素１３１Ｉ和丝裂霉素（ＭＭＣ）为双弹头，采用改良氯胺Ｔ法制备１３１Ｉ抗ＡＦＰＭｃＡｂＭＭＣ（双弹头１）和１３１Ｉ抗ＡＦＰＡｂＭＭＣ（双弹头２），静脉滴注，每月１次，治疗不能切除中晚肝癌３１例（治疗组）．治疗１，２，３次分别占４，１７和１０例，放射剂量（ＭＢｑ／例）均值依次为１９３５１±３７７４，６５１９±２３２４和９９２０±２３０５．结果治后肿瘤缩小率、血清ＡＦＰ下降率和１，２年生存率分别高于同期经动脉插管灌注（ＴＡＩ）或化疗栓塞（ＴＡＣＥ）的对照组（５００％，１５／３０比３００％，９／３０Ｐ＜００５；６６７％，１８／２７比２８０％，７／２５Ｐ＜００１和５００％比３３０％，３４０％比３３％Ｐ＜００１），治疗组病例的进展率（１００％）明显低于对照组（４００％，Ｐ＜００１）．结论双弹头疗效提高，由于抗体、核素１３１Ｉ和抗癌药的协同作用而增强了对癌细胞的杀伤力所致．     

胃十二指肠疾病患者的胃排空功能

了解常见胃十二指肠疾病患者的液体胃排空情况．方法采用放射性核素９９ｍＴＣ标记的液体试餐法，对正常人１８例及慢性胃十二指肠疾病患者４５例，进行液体胃排空功能测定．结果十二指肠溃疡组（ｎ＝１３）胃半排空时间为２８１ｍｉｎ±１４０ｍｉｎ，较正常对照组３９７ｍｉｎ±１４７ｍｉｎ明显缩短（Ｐ＜００５）．ＦＤ及ＣＡＧ组与对照组比较无显著差异（Ｐ＞０２０）．结论ＤＵ患者液体胃排空加快，合并幽门变形者胃排空延缓     

食管通过时间诊断胃食管反流的意义

目的建立坐位食管通过时间（ＥＴＴ）正常参数，并观察反流性食管炎（ＲＥ）患者坐位ＥＴＴ的变化．方法健康志愿者４５例，ＲＥ患者２８例，分别用９９ｍＴｃＤＴＰＡ标记的蒸鸡蛋和牛奶测定坐位固体及液体食物ＥＴＴ．结果健康志愿者固体及液体食物ＥＴＴ分别是６９０ｓ±１７３ｓ及２４７ｓ±０５６ｓ，ＲＥ患者为１１５０ｓ±５７０ｓ及３１６ｓ±１２０ｓ．健康志愿者及ＲＥ患者固体食物ＥＴＴ有差异（Ｐ＜００５）．结论核素显像法测定ＥＴＴ简单准确，对评估食管功能有一定的临床意义．     

乙型肝炎患者血清Pre-S-2抗原的意义

目的研究ＰｒｅＳ２抗原与乙型肝炎患者ＨＢＶ标记的关系．方法血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例及健康献血者２０例，血清用ＲＩＡ法检测ＰｒｅＳ２抗原及用ＰＣＲ法检测ＨＢＶＤＮＡ．结果血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性（１００％）；血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例，ＰｒｅＳ２抗原３０例阳性（６３８％），１７例阴性（３６２％），ＨＢＶＤＮＡ３２例阳性（６８１％），１５例阴性（３１９％），ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性２８例（５９６％），均阴性１４例（３００％）．健康献血者２０例，ＰｒｅＳ２抗原阳性１例（５０％），阴性１９例（９５０％），ＨＢＶＤＮＡ阳性２例（１００％），阴性１８例（８００％），ＰｒｅＳ２抗原及ＨＢＶＤＮＡ均阳性０例（０％），均阴性１８例（８００％）．结论ＰｒｅＳ２抗原可作为预测慢性乙型肝炎患者病情活动与传染的标志．     

糖尿病性胃轻瘫的动力学研究

目的研究糖尿病性胃轻瘫患者胃动力学异常的机制．方法非胰岛素依赖性糖尿病（ｎｏｎｉｎｓｕｌｉｎｄｅｐｅｎｄｅｎｔｄｉａｂｅｔｅｓｍｅｌｉｔｕｓ，ＮＩＤＤＭ）患者３２例，正常人２２例作对照．采用同位素方法测定固体液体胃排空．另外，用胃频谱图机做胃频谱分析．结果ＮＩＤＤＭ患者的固体液体胃半排空时间较正常对照组明显延缓／ｍｉｎ．（９１５±２３７ｖｓ４９２±９２及５９１±１１４ｖｓ３３２±１４８，Ｐ＜００１），固体胃排空延迟主要在排空３０ｍｉｎ以后，液体胃排空延迟主要在６０ｍｉｎ以后；ＮＩＤＤＭ患者中糖尿病性胃轻瘫检出率为５６３％；ＮＩＤＤＭ胃轻瘫患者伴有胃动过速者（４４４％）多于ＮＩＤＤＭ不伴胃轻瘫的患者（７１％，Ｐ＜００５）；ＮＩＤＤＭ患者的胃排空延迟与自主神经病变有关（Ｐ＜００１）；ＮＩＤＤＭ患者的胃排空延迟与外周神经病变、肾脏病变、空腹血糖和病程无关（Ｐ＞００５）．结论ＮＩＤＤＭ患者胃固体液体胃排空延迟，胃轻瘫检出率５６３％，其特点：固体液体胃排空延迟和胃节律紊乱．自主神经病变是引起糖尿病性胃轻瘫的重要因素．     

C-myc,Bcl-2与胃癌生物学行为和细胞凋亡

目的探讨癌基因Ｂｃｌ２，Ｃｍｙｃ的表达变化与胃癌生物学行为和细胞凋亡的关系．方法采用免疫组化ＬＳＡＢ法，检测６０例原发性胃癌组织（男３８例，女２２例，年龄３７岁～７５岁）癌基因Ｂｃｌ２，Ｃｍｙｃ蛋白的表达变化；在普通光学显微镜下对受检组织的ＨＥ片进行形态学测量和凋亡细胞计数．结果受检组织６０例中，Ｃｍｙｃ阳性表达３７例（６２％），其表达与分化程度和临床分期呈显著性相关，且Ｃｍｙｃ阳性组织细胞凋亡指数（０７±０３）明显高于阴性组织（０３±０２）；所检标本中，Ｂｃｌ２阳性表达率为６８％（４１／６０），其中高分化胃癌的阳性表达率明显高于低分化胃癌（３２％ｖｓ９％）（Ｐ＜００５），阳性Ｂｃｌ２组织与阴性Ｂｃｌ２组织比较，前者凋亡指数明显低于后者（０４±０３ｖｓ０９±０５）（Ｐ＜００５）．结论Ｃｍｙｃ与Ｂｃｌ２基因的异常表达是胃癌生物学行为的重要影响因素，二者在胃癌形成过程中均起着一定的作用，并对细胞增生与凋亡有重要调节作用．     

肝炎后肝硬变肝损害与细胞免疫功能(英文)

目的研究肝炎后肝硬变（ＰＨＣ）患者的细胞免疫状态及其与肝功能损害的关系．方法５１例ＰＨＣ患者，包括ＣｈｉｌｄＰｕｐｈＡ级２０例、Ｂ例１８例、Ｃ级１３例和２２例健康对照者，外周血经用ＦｉｃｏｌＨｙｐａｑｕｅ梯度离心分离单个核细胞后，采用３ＨＴｄＲ掺入技术测定了淋巴细胞转化，ＩＬ２和ＮＫ细胞活性．结果在ＰＨＣ患者淋巴细胞转化指数（ＳＩ）、ＩＬ２活性（ＳＩ）和ＮＫ细胞活性（％）较对照组均明显降低（１８１±１３０ＶＳ３４９±２１７，Ｐ＜００１；８１±６０ＶＳ１３６±５８，Ｐ＜００１；４０３±２１７ＶＳ６１３±２０５，Ｐ＜００１）．免疫功能缺陷与ＣｈｉｌｄＰｕｐｈ分级有关，Ｃ级明显低于Ａ、Ｂ级（Ｐ＜００１），Ｂ级低于Ａ级（Ｐ＜００５）．结论ＰＨＣ患者存在细胞免疫功能缺陷，且与肝损害程度有关．     

99mTC_MIBI直肠门脉显影评估普鲁纳洛治疗门脉高压症的疗效

目的采用９９ｍＴＣ＿ＭＩＢＩ直肠门脉显影法测定心肝核素显影比（Ｈ／Ｌ比值）评估普鲁纳洛治疗门脉高压的疗效．方法肝硬变门脉高压患者在普鲁纳洛治疗前后均进行９９ｍＴＣ＿ＭＩＢＩ直肠门脉显影测定，并与对照组结果进行比较分析．结果肝硬变门脉高压者Ｈ／Ｌ显著高于对照组（０．１４±００５，ｎ＝１０，Ｐ＜００１）；肝硬变门脉高压组于普鲁纳洛治疗后Ｈ／Ｌ组较治疗前降低，差异显著（ｎ＝１４，０．５６±０．２２，０．７７±０．２６，Ｐ＝０．０２５）；Ｈ／Ｌ比值＜０．６者曲张静脉破裂出血无复发．结论普鲁纳洛预防肝硬变门脉高压者的曲张静脉破裂出血安全、有效；９９ｍ＿ＴＣ＿Ｍ１Ｂ１直肠门脉显影可作为普鲁纳洛治疗疗效观察的可靠的无创伤性的指标．     

p53 C-myc和P-gp蛋白在胃癌细胞中表达

目的研究胃癌组织中ｐ５３和Ｃｍｙｃ的表达与多药耐药性（ＭＤＲ）的关系．方法应用ＬＳＡＢ免疫组织化学方法研究６７例（男４１例，女２６例，平均年龄４６±１５８岁）胃癌标本中ｐ５３，Ｃｍｙｃ和Ｐｇｐ的表达．结果本组胃癌中ｐ５３阳性３２例（４７８％），Ｃｍｙｃ阳性３７例（５５２％），Ｐｇｐ阳性３９例（５８２％）．淋巴结转移阳性胃癌ｐ５３阳性率（５６９％）和Ｃｍｙｃ阳性率（６４７％）显著高于淋巴结转移阴性的胃癌（Ｐ＜００５）．ｐ５３的异常表达与ｍｄｒ１基因表达呈显著正相关（ｒ＝０６３，Ｐ＜００５），而Ｃｍｙｃ和ｍｄｒ１的表达无明显相关．结论ｐ５３异常表达可增加ｍｄｒ１基因的表达，从而使胃癌细胞获得ＭＤＲ表型     

乙型肝炎及原发性肝癌患者sIL-2R的变化

目的探讨ｓＩＬ２Ｒ水平与乙型肝炎病情的关系及其在原发性肝癌早期诊断中的价值．方法以ＥＬＩＳＡ法动态检测１１３例乙型肝炎及６例原发性肝癌患者ｓＩＬ２Ｒ水平，另选３１例健康体检者作对照组．结果以ｑ检验、ｔ检验进行统计学处理（微机处理，ＰＯＭＳ２００版）．结果各型乙型肝炎ｓＩＬ２Ｒ水平均显著高于正常对照（ＮＣ）组（Ｐ＜００１），其顺序依次为：ＨＣＣ＞ＣＳＨ＞ＣＨ（ＩＩ）＞ＬＣ＞ＣＨ（ＩＩ）＞ＡＨ＞ＣＨ（Ｉ）＞ＮＣ．ＨＣＣ组ｓＩＬ２Ｒ均值达正常值的２倍以上，且与ＣＨ（Ｉ），ＣＨ（Ｉ），ＡＨ间存在显著性差异（Ｐ＜００１，＜００５及＜００５）；ＣＨ（ＩＩ）组显著高于ＣＨ（Ｉ）组（Ｐ＜００１）．ＨＢｅＡｇ阳性组及ＨＢＶＤＮＡ阳性组ｓＩＬ２Ｒ水平显著高于阴性组．结论ｓＩＬ２Ｒ是监测乙型肝炎病情、ＨＢＶ复制及诊断早期原发性肝癌的一项敏感标志．     

固、液体混合餐的胃排空研究

目的和方法:本文以~(131)I-BSA 和99mTc-DTPA 分别作为混合餐固、液体食物的标记物,检测35例慢性胃炎病人和10名健康志愿者的胃排空,其中两例受检者1周内进一步用~(99m)Tc-SC 复查固体排空,比较两次固体排空过程的相关性。在体外对上述3种放射性标记物在胃液、1mol/L NaCl 和0.1mol/L HCl 溶液中消化2小时,检测其稳定性。结果:~(131)I-BSA 和~(99m)Tc-SC 标记的固体食物经消化后的脱标率分别<2.87%和4.63%,~(99m)Tc-DTPA吸附于固相的吸附率<8.36%。固/液体排空曲线明显不同,固体排空有明显的延迟期,半排空时间较长,慢性胃炎病人固/液体排空时间均较正常对照组延长,两种固体标记物的排空曲线相似,相关性为 r=0.989(p<0.01),前、后两次排空相比,最大差值为9.2%,最小差值仅为0.8%。结论:~(131)I-BSA 作为固体标记物有较好的稳定性,可供临床选择用于胃排空的检测。     

The effects of omeprazole on intragastric pH, intestinal motility, and gastric emptying rate.

BACKGROUND: The present study was designed to investigate whether omeprazole changes the characteristics and thereby the functions ascribed to fasting intestinal motility, postprandial motility, postprandial pH, and gastric emptying. METHODS: Ten healthy subjects were investigated. The studies were performed after 10 days of treatment with 40 mg omeprazole daily/placebo. Duodenal pressures and intragastric pH were detected by strain-gauge transducers and a pH electrode attached to a miniature computer. The meal consisted of an omelette labelled with 99mTc-sulphur colloids followed by 150 ml water labelled with 111In-diethylenetriamine pentaacetic acid. RESULTS: The difference in fasting intragastric pH between the two series was highly significant. The profile from the placebo series showed a relationship between phase activity and pH. The pH increased from phase I (median, 1.3; 95% confidence interval (CI), 0.9-1.6) to a maximum at 25% (1.8 (0.9-2.1)) and 50% (1.6 (1.1-3.8)) of cycle duration and decreased thereafter until the end of the cycle. The profile from the omeprazole series showed significantly higher values during the entire cycle but no relationship between phase activity and pH. Pretreatment with omeprazole was followed by a delay in gastric emptying of liquid at 30 min (64% (49%-66%) (omeprazole series) versus 78% (67%-83%); P < 0.01) and solid at 180 min (71% (48%-86%) (omeprazole series) versus 96% (87%-100%); P < 0.01). There was no significant difference in duration of postprandial motility (305 min (157-350 min) (omeprazole) versus 259 min (129-403 min)). CONCLUSIONS: Omeprazole eliminates the temporal relationship between intragastric pH and characteristics of the migrating motor complex and induces a delay in gastric emptying of both liquid and solid. A non-significant increase in duration of postprandial motility may represent a type-II error.     

Smoking delays gastric emptying of solids.

Oesophageal transit and gastric emptying of liquids and solids was measured in eight normal subjects with a single test meal containing In113 labelled water and an omelette labelled with Tc99m sulphur colloid. Each volunteer was studied, basally, whilst continuously smoking, and while chewing nicotine gum. Neither liquid, nor solid oesophageal transit were affected by smoking, or gum. Liquid gastric emptying occurred exponentially and clearance was not affected by smoking nor gum (mean basal t1/2 17.4 (2.7) (SEM) min, smoking t1/2 16.6 (7.4) min, gum t1/2 12.5 (2.9) min). Gastric emptying of solid had three components. An initial mean lag phase increased from 17.5 (2.7) min, to 27.5 (6.1) min (p less than 0.05) during smoking, but was not prolonged by nicotine gum (17.5 (1.1) min). A subsequent linear emptying phase was also slowed by smoking from a mean of 1.01 (0.15)% min to 0.80 (0.15)% min (p less than 0.05), but was not affected by nicotine gum, 1.06 (0.2)% min. A third complex phase of solid gastric emptying was not analysed. Smoking delays gastric emptying of solids, but not liquids; nicotine is not responsible for this effect. This observation may partly explain the adverse effect of smoking in patients with gastro-oesophageal reflux.     

Gastric emptying after segmental gastrectomy for early cancer in the middle part of the stomach.

BACKGROUND/AIMS: We evaluated the quality of life and gastric emptying in patients who had undergone a segmental gastrectomy to treat early gastric cancer in the middle part of the stomach. METHODOLOGY: Thirty patients were considered in this study. Their mean age was 65.5 years (range: 44-83). All of the patients were free from recurrence of their cancer in the follow-up period. This ranged from 5 to 50 months (mean 30). Patients were interviewed at regular intervals to assess their quality of life and to note particular complaints. The upper gastrointestinal tract was assessed endoscopically. A gastric emptying study was performed at 3, 6, and 12 months after surgery. The meal used in this dual-phase study had solid and liquid phases. For the solid phase, 74 MBq of 99mTc sulfur colloid was injected into an egg, which was then hard-boiled. For the liquid phase, 18.5 MBq of (111)In-diethyltriaminopenta acetic acid (DTPA) were mixed into 150 ml of a commercial, elentary liquid diet. RESULTS: Three months after surgery, the patients' main complaints were gastric stasis (25%), heartburn (8%) and belching (8%). The patients gradually became asymptomatic following surgery. Fifty-nine percent were asymptomatic at the 3-month follow-up, 84% at 6 months, and 92% at 12 months. There was no evidence of reflux esophagitis or gastritis after the 3-month follow-up. One patient developed a complicated duodenal ulcer. Initially, the patients all had prolonged gastric emptying of the dual phase meal, compared to normal individuals. The T1/2 for liquid meal emptying was 87+/-18 min at 3 months, 77+/-20 min at 6 months and 50+/-5 min at 1 year after surgery. The last value is the same as for healthy individuals. Solid meal emptying was still prolonged, with an emptying rate of 36+/-9.7% at 2 hours, one year after surgery. CONCLUSIONS: Segmental gastrectomy patients experienced prolonged gastric emptying in the early post-operative period. This improved in the first year after surgery. The quality of life for patients who underwent segmental gastrectomy has been reasonably good in the follow-up period to date.     

Abnormal Intragastric Distribution of a Liquid Nutrient Meal in Patients with Diabetes Mellitus

Disordered gastric motility and emptying arewell known complications of diabetes mellitus (DM), butthe pattern of intragastric distribution of food has notbeen extensively studied in diabetics. We examined the partition of a liquid nutrient meal betweenthe proximal and distal stomach and the relationshipsbetween intragastric distribution of food and gastricemptying (GE) and the symptoms in DM patients with and without autonomic neuropathy (AN).Fourteen healthy volunteers and 20 DM patients (13 withAN; 9 with dyspepsia symptoms) ingested a liquidnutrient meal (250 ml; 437 kcal) labeled with[^99mTc]phytate. Anterior and posterior serial images of thestomach were taken for 90 min with a gamma camera.Regions of interest for the proximal and the distalhalves of the stomach and for the total gastric areawere defined. Counts from each region along timeallowed estimation of GE and the proportion of activityretained in the proximal stomach after meal ingestion(initial) and throughout GE (mean). GE half-times in controls (median; range: 66 min; 29-90 min)were not significantly different from diabetics (76 min;5->150 min, P > 0.10), but abnormal GE was foundin 11 DM patients (seven delayed and four rapid). In DM patients, initial retention inthe proximal stomach (42%; 16-79% ) was significantlylower (P < 0.02) than in controls (55%; 44-71%). Meanretention in the proximal stomach throughout emptying also was significantly lower (P <0.05) in DM patients (43%; 18-58%) than in controls(51%; 32-69%). There were no differences betweensubgroups of patients with normal, delayed, or rapid gastric emptying regarding mean meal retentionin the proximal stomach. Patients with evidence of AN orwith dyspepsia symptoms had significantly decreasedretention of food in the proximal stomach throughout gastric emptying. We concluded that patientswith diabetes mellitus have abnormally decreasedretention of gastric contents in the proximal stomachafter a liquid meal, which seems to be related to the occurrence of autonomic neuropathy anddyspepsia symptoms, but not to disordered gastricemptying.     

Are there changes in gastric emptying during the menstrual cycle?

BACKGROUND: The questions of whether gastric emptying of solids and liquids differs in men and women and whether emptying is influenced by the action of sex hormones on gastric smooth muscle remain unresolved. METHODS: We analysed the gastric emptying of digestible solids (GES), liquids (GEL), and radiopaque indigestible solids (GER) in three groups of healthy volunteers: 50 women in the follicular phase of the menstrual cycle, 50 women in the luteal phase, and 100 men. [99mTc]-labelled diethylenetriamine pentaacetic acid (DTPA) was used as the radioactive marker for digestible solids, and [111In]DTPA was used as the marker for liquids, to time gastric motility after a solid and a liquid meal. GER was evaluated on a different day in abdominal roentgenograms. RESULTS: GES and GEL were slower in women than in men (P < 0.05), but GER was similar in the two sexes. However, there were no significant differences in GES, GEL, or GER between women in the follicular and those in the luteal phase, between plasma concentrations of oestradiol and progesterone and the variables used to characterize gastric emptying. CONCLUSIONS: Evidence of postprandial 'physiologic gastroparesis' was found in women, although no differences were found between men and women in gastric motility during fasting. The rate of emptying was not related to changes in plasma concentrations of sex hormones during the menstrual cycle.     

Biphasic solid and liquid gastric emptying in normal controls and diabetics using continuous acquisition in LAO view

The purpose of this study was to investigate the various phases of gastric emptying using a dual-isotope liquid-solid meal ([^99mTc]Sc egg sandwich and [¹¹¹In]DPTA in water) and continuous acquisition in the left anterior oblique view. The study groups consisted of 10 normal controls and 20 diabetics with symptoms suggestive of diabetic gastroparesis. Solid-phase emptying in both groups almost always had a lag phase followed by linear emptying. Liquid-phase emptying was biexponential in 4/10 normals and 12/20 diabetics, with a short early rapid emptying rate (meanT1/2=48 min in normals and 79 min in diabetics). Solid emptying was delayed in 10, normal in eight, and rapid in two diabetics. Liquid emptying was delayed in 9/10 diabetics who had delayed solid emptying. Diabetics as a group had a significantly delayed solid lag phase (P<0.025), rate of emptying (P<0.05) and percent emptying at 90 min (P<0.025) compared to normal controls. Diabetic liquid emptying was also significantly delayed (P<0.025). The second component of liquid emptying strongly correlated with the solid rate of emptying (r=0.826 in normals and 0.855 in diabetics). Continuous acquisition of gastric emptying studies in the LAO view has allowed us to better define the various phases of solid and liquid gastric emptying.     

Disturbed gastric emptying in the short bowel syndrome. Evidence for a 'colonic brake'.

Gastric emptying of liquid (orange juice containing technetium-99m (99mTc) labelled antimony sulphide colloid) and solid (570 kcal pancake containing 0.5 mm resin microspheres labelled with Indium-111 (111-In)) was measured in seven patients with jejunum and no colon (jejunal lengths 30-160 cm), six patients with jejunum in continuity with the colon (jejunal length 25-75 cm), and in 12 normal subjects. In patients with no colon early emptying of liquid was rapid (median 25% emptying: 7 v 25 min, no colon v normal, p < 0.05); early gastric emptying of solid was rapid in two (each with less than 100 cm jejunum) and normal in the other five. Gastric emptying of liquid and solid for patients with jejunum in continuity with the colon was normal for the first three hours. There was increased liquid and solid retained in the stomach at six hours in both groups of patients (p < 0.01). Small bowel transit time was faster than in normal subjects for liquid in both groups of patients (p < 0.05) and for solid in those with no colon (p < 0.05). Rapid gastric emptying of liquid may contribute to the large stomal output in patients with a high jejunostomy. Preservation of the colon after a major small intestinal resection exerts a braking effect on the rate of early gastric emptying of liquid.     

The Effects of Omeprazole on Intragastric pH,Intestinal Motility,and Gastric Emptying Rate

Background: The present study was designed to investigate whether omeprazole changes the characteristics and thereby the functions ascribed to fasting intestinal motility, postprandial motility, postprandial pH, and gastric emptying. Methods: Ten healthy subjects were investigated. The studies were performed after 10 days of treatment with 40 mg omeprazole daily/placebo. Duodenal pressures and intragastric pH were detected by strain-gauge transducers and a pH electrode attached to a miniature computer. The meal consisted of an omelette labelled with ^99mTc-sulphur colloids followed by 150 ml water labelled with ¹¹¹In-diethylenetriamine pentaacetic acid. Results: The difference in fasting intragastric pH between the two series was highly significant. The profile from the placebo series showed a relationship between phase activity and pH. The pH increased from phase I (median, 1.3; 95% confidence interval (CI), 0.9-1.6) to a maximum at 25% (1.8 (0.9-2.1)) and 50% (1.6 (1.1-3.8)) of cycle duration and decreased thereafter until the end of the cycle. The profile from the omeprazole series showed significantly higher values during the entire cycle but no relationship between phase activity and pH. Pretreatment with omeprazole was followed by a delay in gastric emptying of liquid at 30 min (64% (49%-66%) (omeprazole series) versus 78% (67%-83%); P &lt; 0.01) and solid at 180 min (71% (48%-86%) (omeprazole series) versus 96% (87%-100%); P &lt; 0.01). There was no significant difference in duration of postprandial motility (305 min (157-350 min) (omeprazole) versus 259 min (129-403 min)). Conclusions: Omeprazole eliminates the temporal relationship between intragastric pH and characteristics of the migrating motor complex and induces a delay in gastric emptying of both liquid and solid. A non-significant increase in duration of postprandial motility may represent a type-II error.     

消化性溃疡患者胃排空功能的初步观察

本文对正常人,十二指肠溃疡,胃溃疡患者共66例,用锝~(99)标记的液体试餐,于服用后5分钟、10分钟分别检测胃的排空率及半排空时间。结果显示,无论是早期相的5分钟和10分钟的液体排空速度还是半排空时间,溃疡病患者组与正常对照相比,均未显示差异。没有排空加速或迟缓的表现。由此推论,在治疗中应用与胃的运动有影响的药物(如多潘立酮,颠茄等),并无实际意义.