Is there delayed gastric emptying in patients with multiple system atrophy? An analysis using the 13C-acetate breath test
Is there delayed gastric emptying in patients with multiple system atrophy? An analysis using the 13C-acetate breath test
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DOI：
10.1007/s00415-011-6372-7
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发表时间：
2012-07-01
影响因子：
6
通讯作者：
Inuzuka, Takashi
中科院分区：
文献类型：
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作者：
Tanaka, Yuji;Kato, Tomohiro;Inuzuka, Takashi
根据第二共识声明，自主神经衰竭是诊断多系统萎缩（MSA）的标准之一。胃肠道症状是MSA患者的常见主诉，可能与自主神经系统功能障碍引起的胃肠道运动减少有关。然而，很少有关于MSA患者胃排空的报道。我们对25例MSA患者、20例散发性成人病因不明性共济失调（SAOA）患者和20名健康志愿者的胃排空情况进行了研究，采用c -13-醋酸盐呼吸试验。胃排空功能通过本试验估计为半排空时间（HET）和C-13 %-过量剂量曲线的峰值时间（T (max)），在试餐后4小时收集过期时间，并使用红外分光光度计测定(CO2)-C-13含量。与SAOA组和对照组相比，MSA组胃排空HET和T （max）明显延迟（p < 0.01）。SAOA患者的HET和T （max）与对照组无显著差异。在MSA患者中，HET或T （max）与病程或疾病严重程度之间不存在相关性。这些结果提示MSA患者胃排空明显延迟，并且这种延迟在疾病早期就已经出现。胃排空延迟是自主神经功能衰竭之一，可能是MSA的临床标志。
Autonomic failure is one of the criteria according to the second consensus statement for the diagnosis of multiple system atrophy (MSA). Gastrointestinal symptoms are frequent complaints in patients with MSA and may be associated with reduced gastrointestinal motility due to autonomic nervous system dysfunction. However, there are few reports on gastric emptying in patients with MSA. We investigated gastric emptying in 25 patients with MSA, 20 patients with sporadic adult-onset ataxia of unknown etiology (SAOA), and 20 healthy volunteers using the C-13-acetate breath test. Gastric emptying function is estimated by this test as the half-emptying time (HET) and peak time of the C-13-%-dose-excess curve (T (max)), with expirations collected for 4 h after a test meal and determination of (CO2)-C-13 content using an infrared (IR) spectrophotometer. The HET and T (max) of gastric emptying were significantly delayed in patients with MSA as compared to those in SAOA and controls (p < 0.01). The HET and T (max) were not significantly different between SAOA and controls. No correlation existed between the HET or T (max) and the duration or severity of the disease in MSA patients. These results suggested that gastric emptying was significantly delayed in patients with MSA, and the delay already appeared in the early stage of the disease. Delayed gastric emptying is one of the autonomic failures and may be a clinical marker of MSA.