Journals / Turkish Journal of Gastroenterology / 2000 / Cilt: 11 - Sayı: 4
Sirozlu hastalarda katı gıdaların mide boşalımı: Portal hipertansif gastropati, asit ve serum gastrin düzeyinin mide boşalımına etkisi
- Pages
- 271–276
- DOI
- —
Abstract
Background: This study was undertaken in order to determine the gastric emptying rate of solids in patients with cirrhosis and the factors which may affect this. Methods: Twenty one patients with cirrhosis and 11 healthy controls were included. The patients were classified by the parameters of ascites, portal hypertensive gastropathy and serum gastrin levels that affect gastric mucosal structure and motor functions, and subgroups were then formed. All cirrhotic cases had esophageal varices and 66.6% of patients had endoscopic and histological evidence of portal hypertensive gastropathy. After an overnight fasting period, all subjects ingested a tecnetium 99m labeled solid meal consisting of an egg and toasted white bread. Immediately after ingestion of the meal, subjects were positioned supine under a gamma camera and serial images were recorded continuously for 90 minutes. Half emptying time and the percentage of emptying at 90 minutes was then calculated. Results: Half emptying time was found to be 43±20 min. in cirrhotics and 60±21 in control cases (p<0.05). For this parameter, there was a significant difference between the patients with portal hypertensive gastropathy and the control group (p<0.02). In contrast, there was no significant difference between cirrhotic patients without portal hypertensive gastropathy and the control group. Gastric emptying at 90. mi-nutes was 75±16% and 62±15% in cirrhotics and controls respectively (p>0.05). Serum gastrin levels were 80±29pg/ml in cirrhotics and 49±17pg/ml in control cases (p<0.01). There was no significant difference in serum gastrin levels between patients with (78±30pg/ml) and without (82±29pg/ml) portal hypertensive gastropathy (p>0.05). Conclusions: In cirrhotic patients, gastric emptying half time was decreased, but no difference was observed in the percentage of gastric emptying at 90 minutes. This finding seems to be due to portal hypertensive gastropathy.
Özet
Amaç: Sirozlu hastalarda mide boşalması ve bunu etkileyen faktörleri incelemek amacıyla 21 hasta ve 11 kontrol olgusu çalışmaya alındı.Yöntem: Hastalar asit, portal hipertansif gastropati ve serum gastrin düzeyi gibi gastrik motor fonksiyon ve mukozal yapıyı etkileyecek paremetreler açısından kendi içinde sınıflandırıldı ve alt guruplar oluşturuldu. Sirozlu hastaların tümünde özafagus varisleri mevcuttu. Olguların %66.6'sınde endoskopik ve histolojik olarak portal hipertansif gastropati saptandı. Bir gecelik açlığı takiben teknesyum 99m sülfür kolloid ile işaretli bir yumurtanın, tost ekmeği içine konularak yedirilmesini takiben gamma kamera altına sırt üstü yatırılan hastalarda 90 dakika süreyle dinamik görüntüler kaydedildi. Midedeki radyoaktivitenin %50'sinin boşaldığı zamanı (T:1/2) ve 90. dakikadaki mide boşalım yüzdesi hesaplandı.Bulgular: T:1/2 sirozlu hastalarda 43±20 dakika iken kontrol grubunda 60±21 dakika (p 0.05). Serum gastrin düzeyi sirozlu hastalarda ve kontrol grubunda sırasıyla 80±29 pg/ml, 49±17 pg/ml olarak bulundu(p<0.01). Serum gastrin düzeyi açısından portal hipertansif gastropati olan grup (78±30 pg ml) ile olmayan grup (82±29 pg ml) arasında anlamlı fark saptanmadı. Sonuç: Sirozlu hastalarda mide boşalımı yarılanma süresi kısalmıştır. Geç dönemde ise bu farklılık kaybolmaktadır.