胃食管反流病的胃排空功能研究

目的　探讨胃食管反流病 (GERD)胃液体、固体排空情况及与pH值监测结果的相关性。方法　 15例GERD患者分别进行胃镜检查、2 4h食管pH值监测和放射性核素胃排空功能测定 ,与对照组液体和固体胃排空率、胃半排空时间进行比较 ,分析GERD患者液体、固体排空率与食管炎及 2 4hpH值监测指标之间的关系。结果　GERD组液体胃排空率在 15、30min明显低于对照组 (P<0 0 5 ) ,固体胃排空率在各时间点均低于对照组 (P <0 0 5 )。GERD患者液体半排空时间与pH值监测总积分无相关性 (r=0 0 6 1,P >0 0 5 ) ;固体半排空时间与pH值监测总积分呈直线相关 (r=0 6 43,P <0 0 5 )。结论　GERD患者存在胃液体、固体排空延迟。固体半排空时间与pH值总积分呈直线相关。胃排空延迟可能是GERD发病机制的重要因素。     

胃食管反应流的胃排空功能研究

目的探讨胃食管反流病（ＧＦＲＤ）胃液体、固体排空情况与ＰＨ值监测结果的相关性。方法１５例ＧＥＲＤ患分别进行胃镜检查、２４ｈ食管Ｐ 和放射性核素胃排空功能测定，与对照组液体和固体胃排空率、胃半排空时间进行比较，分析ＧＥＲＤ患液体，固体排空率与食管炎及２４ｈ ｐＨ值监测指标之间的关系。结果ＧＥＲＤ组液体胃排空率在１５、３０ｍｉｎ明显低于对照组（Ｐ〈０．０５），固体胃排空率在各时间点均低于对照组（Ｐ     

超声同步检测正常人远端、近端胃排空运动的研究

目的: 探讨超声同步观察正常人远端、近端胃排空运动的价值.材料和方法: 通过实时超声法检测100例健康人远端、近端胃排空运动,并与胃电图进行对照.结果: 胃窦幽门协调收缩频率3.0±0.8次/min、幅度1.5±0.5cm与胃电图的胃电频率、幅度无明显差异.胃底-体交界处胃液体排空迅速有序,胃半排空时间30.0±4.0min.结论: 超声能准确评价正常胃排空功能状态.     

功能性消化不良患者的胃排空及其与胃窦十二指肠运动的关系

采用同位素γ-照相法对56例FD患者进行胃排空检测,其中8例患者同时采用小气囊测压法进行胃窦十二指肠运动测定。结果显示,①FD患者在餐后30、60及90分钟的胃固-液体排空率均显著低于正常组(P<0.05～0.01)。②胃排空率与胃窦运动指数呈显著正相关(r=0.6759,P<0.01),亦与胃窦十二指肠协调收缩呈显著正相关(r=0.7347,P<0.01)。结论:功能性消化不良患者存在胃排空延迟;胃排空延迟与胃窦十二指肠运动紊乱有关。     

用实时超声研究儿童功能性消化不良症胃运动功能

目的：通过对胃液体排空功能的测定,以探讨实时超声在胃动力学方面的应用价值及其可行性。材料与方法：利用实时超声测定１４５例功能性消化不良儿童及４２例健康儿童胃容积变化及胃底体交界处前后壁内径变化。结果：观察组两种方法测定的胃液体排空时间均较对照组明显延长,二组间有显著差异,胃排空时间呈正相关。结论：儿童功能性消化不良与胃动力障碍有关。     

睡眠剥夺对大鼠胃运动及相关胃肠激素影响的研究

目的观察睡眠剥夺对胃排空、胃电活动及降钙素基因相关肽(CGRP)和一氧化氮(NO)的影响。方法将192只SD大鼠随机均分为3组，即急性睡眠剥夺组(A组)、慢性睡眠剥夺组(B组)、空白对照组(C组)；每组又随机均分为2个亚组．每亚组32只大鼠，即AI、AII．BI、BII．CI、CII；每个亚组再随平均分为4个小组．每小组8只大鼠。利用放射分析法．使用放射性核素锝(^99m Tc)．采取液相胃排空的方法检测胃的排空，利用浆膜法检测胃电的变化；利用生化法和放免分析法测定大鼠血浆中的CGRP、NO含量。结果急性睡眠剥夺导致胃排空速率改变．随着睡眠剥夺时间的延长，胃的排空速率逐渐降低；胃电活动在餐前逐渐降低．而餐后无明显规律．呈现紊乱状态；随着睡眠剥夺时间的延长血浆中CGRP的水平，逐渐降低，而NO水平却逐渐升高。慢性睡眠剥夺导致胃排空速率降低．但随着睡眠剥夺时间的延长，胃的排空速率未再发生更为明显的变化．呈现低排空状态；胃电活动在餐前、餐后均无明显规律，呈现紊乱状态；血浆中CGRP的水平随着睡眠剥夺时间的延长。呈现低水平状态．但与干预时间的关系不明显；NO水平呈现相对较高状态．且与干预时间关系不明显。结论睡眠剥夺对胃运动有较为明显的影响。急性睡眠剥夺产生的影响相对显著．导致胃运动功能的降低．而且可以引起大鼠血浆中某些胃肠道激素水平的改变；慢性睡眠剥夺对胃运动也产生影响．导致其功能紊乱，而且影响作用较为持久。     

冷水刺激前庭器官对大鼠胃活动的影响

目的观察冷水刺激前庭器官对大鼠胃活动的影响。方法用水囊法观察冷水刺激前庭器官时,大鼠胃运动的变化。放射免疫技术测定单侧前庭损伤后大鼠血液中胃泌素、胃动素的含量。结果对照组大鼠冷水刺激后,胃运动频率在前3 min内明显下降(P<0.05),胃内压在前2 min明显下降(P<0.05)。假破坏组和单侧迷路破坏组冷水刺激健侧前庭后,胃内压和胃运动频率的变化与正常组相似。单侧迷路破坏2周的大鼠胃运动频率和胃内压与刺激前相比明显下降(P<0.05)。放免检测还发现,单侧迷路破坏组大鼠胃动素和胃泌素含量明显低于假破坏组(P<0.05)。结论 1)冷水刺激前庭器官抑制大鼠胃运动;2)单侧迷路破坏抑制大鼠胃运动的频率和幅度,降低血液中胃泌素和胃动素含量。     

急性缺氧对飞行员胃液排空功能的影响

为探讨急性缺氧对飞行人员胃液体排空功能的影响，在常压下吸入不同浓度氧（17％、16％、14％、12％、10．5％及9％）的低氧混合气体30min，采用B型超声波在实验前后分别测量了64名男性飞行员的胃液体排空功能。结果表明，吸入17％低氧混合气胃排空延迟，但经统计学处理无显著性差异（P＞0．05），吸入16％以下的低氧混合气后胃排空延迟，经统计学处理有显著性差异（P＜O．01），且随着缺氧程度加重，胃液体排空时间延长更加明显。提示当发生高空缺氧时，应考虑到缺氧对胃排空有抑制作用这一因素。     

营养不良患儿胃运动及排空检测

目的 研究营养不良患儿的胃动力及排空.方法应用B型实时超声对30例营养不良患儿液体试验餐后的胃运动与排空功能进行检测.结果 与正常组比较,营养不良患儿餐后胃体蠕动和胃窦收缩频率明显减少,液体胃排空速度明显减慢（P〈0.01）.结论 提示对营养不良症的治疗可应用促进胃动力药物（如吗丁林,普瑞博恩）或采取其他相应措施,以增加胃排空速度,增加能量的摄入,提高治疗效果.     

双核素试餐单光子发射计算机体层摄影术对飞行人员胃运动功能研究

目的　研究飞行人员胃排空的特点，加强卫勤保障工作。　方法　应用双核素单光子发射计算机体层摄影术（ＳＰＥＣＴ）技术对６４ 例飞行人员和３４ 例同一地区地勤人员进行胃排空检测。　结果　飞行人员组液体胃排空与地勤人员一样均呈指数式排空曲线，两者间无显著性差异（Ｐ＞ ０．０５）；固体食物胃排空，飞行人员组与地勤人员组类似，均呈双相幂指数函数曲线，排空前存在延迟时间Ｔ１，但飞行人员组Ｔ１ 明显缩短，为（３．１±２．８）ｍ ｉｎ，两组间有显著性差异（Ｐ＜ ０．０５）；４０．１％ 的飞行人员Ｔ１ 异常，其中３２．８％ Ｔ１ 消失，７．３％ Ｔ１ 延迟；全胃半排空时间（Ｔ１／２ ）与近端胃半排空时间（ＰＴ１／２）两组间未见明显不同；Ｔ１／２与ＰＴ１／２呈高度相关（ｒ＝ ０．８９，Ｐ＜ ０．０１）；未发现ＰＴ１／２与Ｔ１ 间有相关关系。　结论　飞行人员组固体胃排空障碍可较早地由Ｔ１ 反映出来，因此及时检测胃排空功能对飞行人员消化系统保健工作具有重要意义     

Relationship between gastric emptying and gastroesophageal reflux in infants and children

PURPOSE: The aim of our study was to evaluate the relationship between gastric emptying and gastroesophageal reflux (GER) in infants and children. METHODS AND MATERIALS: One hundred eight patients (pts) between 3 months and 5 years of age (77 boys, 31 girls) with clinical suspicion of GER disease were included in the study. Patients were divided into 2 groups according to the age range: group A, 0-2 years (57 pts), and group B, 2-5 (51 pts) years. Each group was divided into 2 subgroups according to the scintigraphic study as GER-positive and -negative. Cow's milk with Tc-99m sulfur colloid as radiotracer was used. Gastric emptying was expressed as the half emptying time (T1/2). The detection of activity in the esophagus at any time during scintigraphy was considered an indicator of GER episodes. Reflux episodes were graded as grade 1 if activity was detected on one or 2 frames and grade 2 if activity was detected on more than 2 frames. RESULTS: Forty of the 108 patients (37%) had GER findings on scintigraphy. The comparison of gastric emptying time between positive GER scintigraphy and negative GER scintigraphy groups was not statistically significant in any age group. No association was found between age and rate of gastric emptying time. Although the comparison of T1/2 between grade 1 patients and the GER-negative group was not statistically significant, grade 2 patients showed significant differences and had prolonged gastric emptying times. Mild statistical correlation between the number of reflux episodes and gastric emptying half time was found. CONCLUSIONS: As a conclusion, the relation between gastroesophageal reflux and delayed gastric emptying cannot be ignored. Our results support delayed gastric emptying to be a pathogenetic factor in gastroesophageal reflux in infants and children.     

贲门癌切除术后残胃排空功能变化

目的 观察贲门癌术后残胃排空功能变化,探讨改善病人术后生活质量的方法。方法 用豆奶粉４０ｇ,水２００ｍＬ,加入１８．５ＭＢｑ＾９９Ｔｃ＾ｍ－ＤＴＰＡ,制成试验餐,于术后１８￣２０ｄ例行贲门癌近端胃次全切除患者,和５例健康人（Ｎ组）进行核素胃排空检查。     

Warm or cold contrast medium in the micturating cystourethrogram (MCUG): which is best?

AIM: The purpose of this study was to determine what difference using room temperature ("cold") or body temperature ("warm") contrast medium had on the outcome of MCUG examinations in infants under 1 year of age. MATERIALS AND METHODS: One hundred infants (50 males and 50 females) referred for an MCUG were identified. Individuals with known bladder neuropathy were excluded. Each was randomized to receive either warm or cold contrast medium. The screening time, volume of contrast instilled, number of attempts at voiding, patient distress, completeness of bladder emptying and incidence of reflux were measured and the results between the two groups compared. RESULTS: No difference was found between the two groups with regards to screening time, volume of contrast instilled or number of attempts at voiding. There was a statistically significant (p<0.05, chi square) difference in distress levels, with more children crying during instillation of cold contrast medium than warm. Bladder emptying was more often to completion when using cold contrast medium (32 compared with 16%), and vesicoureteric reflux (VUR) was more commonly demonstrated when using warm contrast medium (16 compared with 6%), although these values did not reach statistical significance. CONCLUSION: Warm contrast medium causes significantly less distress than cold contrast medium, but does not prolong screening time or increase the volume of contrast required.     

电针足三里穴对LPS刺激后大鼠胃排空功能和延髓迷走孤束复合体内的神经元Fos表达的影响

目的观察电针足三里穴干预后腹腔注射细菌内毒素(LPS)大鼠的胃排空功能和延髓迷走孤束复合体内神经元Fos的表达变化及其意义。方法雄性SD大鼠40只,随机分为空白对照组、LPS组、LPS后电针足三里穴组和LPS后电针非经非穴组,每组10只。采用免疫组织化学方法,观察并计数大鼠延髓迷走孤束复合体内神经元Fos的表达并计算各组动物的胃排空率。结果腹腔注射细菌内毒素(LPS) 2·5h后大鼠的胃排空率明显降低至20·7 %±4·5 %,迷走孤束复合体内Fos阳性神经元数目明显增加至83·2±6·6 ;LPS后电针足三里穴组大鼠的胃排空率明显升高至44·1 %±6·2 %,迷走孤束复合体内Fos阳性神经元数目明显减少至37·9±3·8 ,与LPS组比较有显著性差异(P<0·01) ;LPS后电针非经非穴组的胃排空率和迷走孤束复合体内Fos阳性神经元数目与LPS组无明显差异。结论腹腔注射LPS对大鼠胃排空功能有明显的抑制作用;电针足三里穴对LPS大鼠的胃排空功能具有良性的调节作用,此作用与其保护性调节延髓迷走孤束复合体内的神经元功能状态有关。     

核素胃排空在近端胃手术中的实验研究

目的：探讨近端胃手术不同术式后胃排空功能的改变,应用ＳＰＥＣＴ液体胃排空方法测定胃半排时间（ＧＥｔ１／２）,方法：４０只大白鼠分成４组,每组均行选择性迷走神经干切断术,Ａ组未另附加其它要式,Ｂ组附加幽门成形,Ｃ组行近端胃切除,Ｄ组行近端胃切除附加幽门成形,术前及术后１,２,３周分别行核素胃排空显像测定ＧＥｔ１／２。     

Simultaneous assessment of gastric accommodation and emptying: studies with liquid and solid meals.

The aim of this study was to develop a scintigraphic test to measure gastric emptying and accommodation simultaneously. METHODS: Gastric emptying and accommodation were measured in healthy subjects. To determine gastric accommodation, the stomach was imaged with SPECT 20 min after intravenous administration of 185 MBq (5 mCi) (99m)Tc-pertechnetate. After ingestion of 11 MBq (300 micro Ci) (111)In-diethylenetriaminepentaacertic acid in a liquid nutrient drink or an (111)In-oxine-labeled egg sandwich, dual-isotope imaging assessed SPECT gastric dimensions and gastric emptying every 20 min up to 240 min. Gastric accommodation was calculated as the percentage change in planar (2-dimensional) gastric cross-sectional area (CSA) using a left anterior oblique planar projection and the percentage change in total SPECT gastric voxel counts (3-dimensional) compared with the baseline image. RESULTS: With the liquid nutrient drink (9 subjects), maximal mean CSA (158% +/- 12% of baseline; P < 0.05) occurred 40 min after meal ingestion, when only 69% +/- 3% of the radiolabeled liquid nutrient drink remained in the stomach. At 120 min, mean CSA was 125% +/- 8% of baseline, but only 35% +/- 3% of the liquid nutrient drink remained in the stomach. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred 20 min after meal ingestion (189% +/- 25% of baseline). With the solid egg meal (10 subjects), maximal total CSA (159% +/- 13% of baseline) occurred immediately after meal ingestion; total CSA remained significantly increased above baseline for the first 3 h after ingestion of the egg meal, despite only 12% +/- 4% gastric retention at 3 h. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred immediately after the meal (184% +/- 19% of baseline). CONCLUSION: This method permits simultaneous measurement of gastric emptying and accommodation. In healthy subjects, the gastric accommodation response is prolonged and persists despite nearly complete emptying of a liquid or solid meal.     

Gastric emptying with repeated drinking during running and bicycling

The high prevalence of gastrointestinal complaints in long-distance runners makes the movements specific to this type of exercise suspected of causing a disruption of normal gastrointestinal function. Gastric emptying rate is one indicator thereof. In the present study trained volunteers performed similar repeated fluid ingestion tests while running and while bicycling for 80 min at 70% VO2max. Control tests at rest were also conducted. Two drinks containing carbohydrate were tested, one hypertonic, and one isotonic. Artificially sweetened water was used as a control. Gastric emptying rate of the isotonic drink, expressed as a percentage of the volume in the stomach at the beginning of each measurement period, did not differ between cycling and running during the first 40 min and was faster during cycling than during running between 40 and 80 min. With the hypertonic drink no differences between cycling and running were observed. In comparing gastric emptying rates after each sequential bolus, at rest, the isotonic drink was observed to maintain a high emptying rate, equal to that of water, whereas the hypertonic drink emptied more slowly after the first 20-min period. A similar pattern was observed during both running and cycling. The isotonic drink continued to empty quickly after the initial 20 min, whereas GE rate of the hypertonic drink decreased after the initial 20 min.     

Sonographic comparison of gastric emptying of broth and water: is there a promoting cephalic factor?

PURPOSE: To examine the emptying times of broth and water, and explore the possibility of a cephalic influence on gastric emptying. MATERIAL AND METHODS: On different days each of twelve healthy volunteers had meals of either 350 ml water or 350 ml broth. Subsequently ten volunteers had meals of water alone and of water followed by sham feeding with broth. The antral area was determined at sonography five times before the meal as a baseline, and every 1-4 minutes after the meal. The time until the antral area had decreased to 150% of baseline (T150) was determined and used as surrogate expression of gastric emptying time. RESULTS: The mean T150 was for water 20.3 min (range 12-40), and was for broth significantly shorter 12.6 min (5-21), P = 0.0020. In the subsequent series the mean T150 was 28.5 min (18-49) for water, and significantly shorter for water followed by sham feeding, 22.8 (14-40), P = 0.0078. CONCLUSION: Broth empties faster from the stomach than plain water, probably because of a "cephalic phase" stimulation of gastric motility via the vagus nerve.