ECT胃排空测定技术对功能性消化不良胃排空患者临床评分和血浆酰基化ghrelin水平的评价作用

Emission computed tomography for evaluation of factors influencing gastric emptying in patients with functional dyspepsia

目的:探讨应用发射型计算机断层扫描(emission computed tomography,ECT)技术对功能性消化不良胃排空的影响因素.方法:收集2012-06/2015-04延边大学附属医院收治的功能性消化不良胃排空患者的临床资料72例作为实验组A.选取经ECT核素标记检测提示胃排空延迟者72例为实验组B.选取同时期来延边大学附属医院进行健康体检的志愿者72例作为对照组.对实验组A进行SPECT胃排空检测.实验组B采取口服西沙比利治疗.观察实验组A和对照组T1/2时间、最大残留率(maximum rate of residual,EAOM)、全胃及各分区面积,观察实验组B治疗效果.结果:实验组A的T1/2在近端胃、远端胃方面,均显著长于对照组(P<0.05).实验组A EAOM在近端胃、远端胃、中间横带(midgastric transverse band,MTB)区方面,均显著高于对照组(P<0.05).实验组A在近端胃、远端胃、MTB区、全胃的面积方面,均显著高于对照组(P<0.05).实验组B采取西沙比利治疗.72例患者近胃端T1/2从69.24 min±9.33 min下降至48.55 min±8.64min,患者残留率从42.88%下降至29.99%,治疗后效果优于治疗前,治疗前后比较,差异有统计学意义(P<0.05);患者服药前MTB宽度为3.33 cm±0.09 cm,服药后MTB宽度为2.68 cm±0.09 cm,治疗后MTB宽度低于治疗前,治疗前后比较,差异有统计学意义(P<0.05).结论:应用ECT技术能够检测功能性消化不良胃排空的影响因素,患者经西沙比利治疗后,效果较好.

AIM： To explore the factors influencing gastricemptying in patients with functional dyspepsia by emission computed tomography（ECT）.METHODS： Seventy-two patients with functional dyspepsia were included in a study group（group A）, 72 patients with delayed gastric emptying as revealed by ECT included in another study group（group B）, and 72 healthy volunteer comprised a control group. Group A was tested by SPECT,and group B was treated with cisapride. T1/2,maximum gastric residual rate, and the areas of the entire stomach and different parts were compared. Clinical effects for group B were observed.RESULTS： The T1/2 values in the proximal and distal stomach for group A were higher than those of the control group（P 〈0.05）. The maximum gastric residual rates in proximal,distal stomach, and midgastric transverse band（MTB） were significantly higher in group A than in the control group（P 〈0.05）. The areas of proximal, distal stomach, MTB, and total gastrectomy were significantly higher in group A than in the control group（P 〈0.05）. After treatment with cisapride, T1/2 values were better than before treatment in group B（P〈 0.05）. Gastric residual rate was also better after treatment than before treatment（P 〈0.05）. The width of MTB after treatment was lower than that before treatment（P〈 0.05）.CONCLUSION： ECT can be used to assess factors influencing gastric emptying in patients with functional dyspepsia, and cisapride has good clinical effects in these patients.