131I-白蛋白固体食物标记物用于研究胃排空

目的评价１３１ＩＢＳＡ作为胃固体排空标记物的稳定性和临床应用价值．方法以１３１ＩＢＳＡ和９９ｍＴｃＤＴＰＡ分别作为混合餐固、液体食物的标记物，检测３５例慢性胃炎患者和１０名健康志愿者的胃排空，其中２例受检者１周内进一步用９９ｍＴｃ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／ＬＮａＣｌ和０１ｍｏｌ／ＬＨＣｌ溶液中消化２ｈ，检测其稳定性．结果１３１ＩＢＳＡ和９９ｍＴｃＳＣ标记的固体食物经消化后的脱标率分别＜２８７％和４６３％，９９ｍＴｃ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，慢性胃炎患者固、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１３１ＩＢＳＡ固体标记物稳定性较好，可用于临床胃排空的检测．

131 I labelled BSA solid food in measurement of gastric emptying

AIM To estimate the clinical value of 131 I BSA (bovine serum album) solid food in the determination of gastric emptying. METHODS A standardized meal labeled with dual isotopes ( 131 I BSA as solid phase and 99m Tc DTPA as liquid phase) was employed to measure gastric emptying (GE) in 35 patients with chronic gastritis and 10 healthy controls. In 2 of them, GE was reexamined using another solid marker 99m Tc SC on a separate day within one week. The correlation coefficient between the repeated solid emptying curves was analysed. The labelled meal were incubated in vitro in human gastric juice (pH 2 0), 1mol/L NaCl (pH 7 0) and 1mol/L HCl (pH 1 0) for 2 hours, and their stability was detected. RESULTS The percentages of 131 I BSA and 99m Tc SC dissociated from the solid phase or 99m Tc DTPA sedimented from the liquid phase in three digestive solutions were less than 2 87%, 5 16% and 8 36%, respectively. Solid and liquid emptying patterns were significantly different. Patients with chronic gastritis had remarkable delay of gastric emptying for both solid and liquid food. Solid emptying parameters for 131 I BSA were significantly correlated to those for 99m Tc SC ( r =0 989, P <0 01). Intervariability of solid emptying for 131 I BSA and 99m Tc SC showed a maximal difference of 9 2% and a minimal difference of 0 8%. CONCLUSION 131 I BSA labelled egg has high stability in different solutions and a pattern of emptying similar to that of 99m Tc SC, suggesting that 131 I BSA is a valuable candidate for digestive solid emptying. A combined use of 131 I BSA, 99m Tc DTPA and 111 In EHIDA simultaneously in the measurement of gastric emptying and bile reflux is anticipated.