核素胃排空检查在功能性消化不良患者中的临床应用

Radionuclide gastric emptying scintigraphy in patients with functional dyspepsia

目的:前瞻性研究评价放射性核素标记固体试餐胃排空检查对功能性消化不良(function dyspepsia,FD)患者及正常对照者胃排空功能的测定.方法:应用双探头SPECT对42例FD患者及30例对照者进行放射性核素标记物99m锝-二乙基三胺五乙酸(99mTc-DTPA)标记鸡蛋固体试餐胃排空检查,分别以方法1试餐前位放射性、方法2试餐前、后位放射性的算术平均数及方法3试餐前、后位放射性的几何平均数为纵坐标,时间为横坐标绘制每个受试者的胃排空曲线并计算半排时间及60、120 min胃排空率,比较3种计算半排时间方法的差异及FD患者与对照者半排时间及60、120 min胃排空率的差异.结果:3种计算半排时间方法差异的比较采用单因素方差分析,其中方法1与2计算的半排时间之间差异不具有统计学意义(P=0.808,P=0.243,P>0.05),方法1、2与3计算的半排时间之间差异具有统计学意义(1与3:P=0.007,P=0.000;2与3:P=0.035,P=0.023;P<0.05);3种方法计算FD患者与对照者胃排空的半排时间及60、120 min胃排空率之间差异的比较采用t检验,且差异均具有统计学意义(P=0.000);分别以对照组半排时间为诊断标准,方法1诊断出80.9%(34/42)FD患者的半排时间延长,方法2诊断出71.4%(30/42),方法3诊断出90.5%(38/42).结论:核素99mTc-DTPA固体试餐胃排空检查能够简单、定量反映胃排空的功能状态,为FD的诊断及研究提供客观、准确的依据.

AIM： To assess the use of gastric emptying scintigraphy with solid test meal in patients with functional dyspepsia （FD） and normal subjects. METHODS： Forty-two patients with FD and 30 normal subjects underwent gastric emptying scintigraphy with 99mTc-DTPA labeling egg solid meal. The standard curve of gastric emptying was plotted to figure out the half-time of gastric emptying and emptying rate at 60 and 120 min by three different methods： method 1 with the radioactivity of the anterior view, method 2 with the mean value of and method 3 with the geometric mean of the radioactivity of the anterior and pastier views as the y-axis of the standard curve of gastric emptying, respectively. The differences in half-times and gastric emptying rates at 60 and 120 rain figured out by the three different methods were compared between patients with FD and normal subjects RESULTS： One-way analysis of variance was performed to compare the differences in half-times. The half-time figured out by method 1 did not differ significantly from that by method 2 （P = 0.808, P = 0.243, P 〉 0.05）, but the half-time figured out by method 3 differed significantly from those by methods 1 and 2 （1 vs 3： P = 0.007, P = 0.000; 2 vs 3： P = 0.035, P = 0.023; P 〈 0.05 for all）. The half-time and gastric emptying rates at 60 and 120 rain differed significantly between FD patients and normal subjects （P = 0.000）. Method 1 figured out 80.9%, method 2 figured out 71.4% and method 3 figured out 90.5% of FD patients had longer half-time than normal subjects. CONCLUSION： Radionuclide 99mTc-DTPA gastric emptying scintigraphy with solid meal is a simple, accurate, quantitative and physiologic method for measuring gastric motility in FD patients.