OBJECTIVE: To investigate whether gastric antral motor function, evaluated with scintigraphy, predicts GE. To explore whether motor testing with symptom recording predicts day-to-day symptoms in patients with dyspepsia.
METHODS: GE was determined using a scintigraphic solid-meal protocol (296 kcal, 35% fat). Antral motility was estimated from 10 min of scintigraphic time-activity curves acquired 40 min after meal consumption. An antral motility index (MI) was derived from contraction amplitude and frequency. Intra-gastric distribution of the meal on scintograms at 1 h (IGD1) was determined. Meal-induced symptoms were evaluated by questionnaire. Patients completed the Gastroparesis Cardinal Symptom Index Daily Diary (GCSI-DD) for 14 days.
RESULTS: Twelve healthy participants and 23 prospectively recruited patients completed the study. Nine patients had delayed, and 2 had rapid, GE. In univariate analysis MI explained 42% of GE half-time. In multivariate analysis MI and GE half-time explained 25% of the variance in meal-induced symptoms. While scintigraphic evaluation of gastric motor function with symptom recording explained 80% of the variance in the GCSI-DD, meal-induced symptoms were the only significant predictor. However, among patients with delayed GE, MI, GE half-time, IGD1, and meal-induced symptoms all significantly predicted GCSI-DD.
CONCLUSIONS: Antral motility predicts GE. In exploratory analyses, only meal-induced symptoms predicted daily symptoms among patients with dyspepsia. However, motor function also predicted symptoms in patients with delayed GE.
目的:探讨胃窦运动功能,用闪烁显像法评估,预测GE。探讨带有症状记录的运动测试是否可以预测消化不良患者的日常症状。
方法:使用闪烁扫描固体粉方案(296千卡,35%的脂肪)。根据进食后40分钟获得的闪烁显像时间-活动曲线的10分钟来估计窦运动性。从收缩幅度和频率得出窦运动指数(MI)。在1小时(IPD1)的闪烁图中确定了餐食的胃内分布。通过问卷调查评估膳食诱导的症状。患者完成了长达14天的胃轻瘫基数症状指数每日日记(GCSI-DD)。
结果:12名健康参与者和23名前瞻性招募患者完成了研究。九名病人延误了,和2有快速,。在单变量分析中,MI解释了42%的GE半衰期。在多变量分析中,MI和GE半衰期解释了进餐引起的症状变化的25%。尽管通过症状记录对胃运动功能进行闪烁显像评估可以解释GCSI-DD中80%的变异,膳食诱导的症状是唯一显著的预测因素。然而,在GE延迟的患者中,MI,GE中场休息,IGD1和进餐诱导的症状均显着预测了GCSI-DD。
结论:窦运动可预测GE。在探索性分析中,在消化不良患者中,只有餐食诱发的症状可以预测每日症状.然而,运动功能还可以预测GE延迟患者的症状。