超声法与放射性核素法诊断糖尿病性胃病的比较

Comparison of ultrasonography with radionuclide for the diagnosis of diabetic gastropathy

目的以放射性核素法为标准，研究超声胃窦中点面积法测胃排空功能的可靠性，应用于糖尿病胃病（ＤＧＰ）的诊断，及对方法进行简化。方法对照组 １４例，糖尿病组 １５例，分２ ｄ接受超声和核素检查。结果两组两种方法胃排空曲线相似，两种方法得到的两组胃半排空时间（Ｔ ）十分相近，差异无统计学意义（Ｐ＞０．０５），且具良好相关性（ｒ＝０．７６，０．９６）；以对照组超声Ｔ ±２ ｓ即８７ｍｉｎ和１１７ｍｉｎ为诊断标准，糖尿病人１３例存在ＤＧＰ，４例胃排空过速，９例胃排空延迟。对照组餐后３３，８７，１１７ ｍｉｎ的胃窦扩张率Ｒ_(３３)１００％，Ｒ_(８７)＞５０％，Ｒ_(１１７)＜５０％；延迟组Ｒ_(３３)９７％，Ｒ_(１１７)＞５０％；过速组校正Ｒ３３＝１００％，相应的Ｒ８７＜５０％。结论超声法检查胃排空可靠，测定空腹和餐后３３，８７，１１７ｍｉｎ的胃窦面积变化可诊断ＤＧＰ及分型，即胃排空过速型和胃轻瘫，简化超声检查具可行性。

Objective Taking the radionuclide as criteria to study the reliability of the method assessing gastric emptying via measuring the cross - sectional area of the middle gastric antrum by ultrasonography, diagnostic DGP and simplify the method. Methods The gastric emptying time was measured by ultrasonography and radionuclide in two days in 14 healthy volunteers and 15 diabetic patients. Results The two gastric emptying curves of the two groups detected by ultrasonography resem- bled those detected by radionuclide. The T of the two groups measured by the two techniques were very close(P > 0.05), there were significant correlation between them(r = 0.76,0.96). The ultrasonic T ± 2 s of the control group were 87 min and 117 min, when they were defined as the diagnostic criteria, there were thirteen diabetic patients suffered from DGP, 4 of them were accelerated gastric emptying, the others were delayed gastric emptying. The postprandial antral dilation rates at the 33th point (R_(33)) assessed by ultrasonography were l00%, R_(87) > 50% and R_(117) < 50% in all of the control group, while the R_(33) were close to 100% in 15 patients, R_(87) < 50% in the accelerated group and R_(117) > 50% in the delayed group. Conclusion The method is reliable. After detecting the antial areas at fasting state, R_(33), R_(87) and R_(117), DGP may be diagnosed and divided into two types - accelerated type and gastroparesis. Ultrasonography can be simplified.