中性红清除法测定人胃粘膜血流量的研究

A study on measurement of gastric mucosal blood flow by neutral red clearance technique

目的探讨中性红(neutral red,NR)测定人体胃粘膜血流(GMBF)的可行性及临床意义。方法正常组11名先静注负荷量 NR(300或400μg/kg),然后按上述剂量恒速静点。1h 后肌注五肽胃泌素(6μg/kg),同步定时收集胃液和采血至2h 结束后测定 NR 浓度并进行各项计算。12例慢性浅表胃炎(CSG 组)及13例十二指肠溃疡病(DU 组)以 NR 300μg/kg给药,用同法测定1h 结束。结果正常组不同时间、不同剂量下NR 的 G/B 比率基本稳定(P>0.05),GMBF 与泌酸量和胃液分泌量的 r 分别为0.84和0.87。CSG 组各测定值接近正常组。DU 组 GMBF 下降明显(P<0.01),基础泌酸量与正常组和 CSG组的差异无显著性(P>0.05)。结论 NR 清除法测定人体 GMBF 稳定可靠,重复性好。正常组和 CSG 组的GMBF 与泌酸量、胃液分泌量呈正相关,而 DU 组的 GMBF 与泌酸量的相关性发生改变。

AIMS To study the measurement of human gastric mucosal blood flow(GMBF)by neutral red clearance technique and its clincial significance. METHODS Eleven normal young adults were loaded with neutral red (NR)at a priming dose of 300 or 400μg/kg iv,followed by NR 300 or 400 μg/(kg·h)iv at constant speed for maintenance.One hour later 6 μg/kg of gastrin were given intramuscularly.Meanwhile, gastric juice and blood samples were harvested at fixed intervals for two hours for the determination of NR concentration and calculation.Patients with chronic surfacial gastriris(n=12 CSG group)and duodenal ulcer(n=13,DU group)were studied in the same way. RESULTS G/B ratios of NR were stable(P>0.05,P>0.05)in nor- mal group at different time or doses.Correlation coefficient value of GMBF to gastric juice and its acidity was 0.87 and 0.84 respectively.In CSG group,it was similar to those of normal group.In DU group,however,GMBF decreased significantly(P< 0.01),while no significant difference was found between basic gas- tric acid secretion and those of the normal group or CSG group. CONCLUSIONS Human GMBF can be stably and accurately meatured by NR clearance technique and well repeated.GMBF is positively correlated to gastric juice secretion or acidity in normal and CSG groups,but the correlation varied in DU group.