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。

Study on gastric emptying for meals composed of both solid and liquid food.

PURPOSE:This study investigated the clinical value of ~(131)I-BSA and ~(99m)Tc-DTPA in the estimination of gastric emptying time for solid and liquid food.METHODS:A standardized meal labeled with dual isotopes(~(131)I-BSA as solid phase and ~(99m)Tc-DTPA as liquid phase)was em- ployed to measure gastric emptying(GE)in 35 patients with chronic gastritis and 10 healthy con- trols.GE in 2 participants were further examined using another solid marker ~(99m)Tc-SC on a sepa- rate day within one week.The correlation coefficient between the repeated solid emptying curves was analysed.In vitro,the labelled meals were incubated in human gastric juice(pH2.0),1mol/L NaCl(pH7.0)and 1mol/L HCl(pH1.0)over a period of 2 hours to determine the stability of the three nuclides.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 the three digestive solutions were less than 2.87%,5.16% and 8.36% respectively.In in vivo study,the solid and liquid emptying pat- terns were significantly different.Patients with chronic gastritis showed remarkable delay of gas- tric emptying for both solid and liquid food.Solid emptying parameters for ~(131)I-BSA were signifi- cantly 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%. CONCLUSIONS:~(131)I-BSA labelled egg showed high stability in different solutions and had an emptying pattern similar to that of ~(99m)Tc-SC,suggesting that ~(131)I-BSA is a valuable candidate for solid emptying.A combined use of ~(131)I-BSA ~(99m)Tc-DTPA and ~(111)In-EHIDA in the measurement of gastric emptying and bile reflux is recommended.