A stable isotope breath test with a standard meal for abnormal gastric emptying of solids in the clinic and in research
A stable isotope breath test with a standard meal for abnormal gastric emptying of solids in the clinic and in research
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DOI：
10.1016/j.cgh.2008.01.009
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发表时间：
2008-06-01
影响因子：
12.6
通讯作者：
Zinsmeister, Alan R.
中科院分区：
文献类型：
--
作者：
Szarka, Lawrence A.;Camilleri, Michael;Zinsmeister, Alan R.
背景和目标：本研究的目的是验证[C-13]-钝顶螺旋藻胃排空（GE）呼吸试验（GEBT）与标准餐。研究方法：38名健康志愿者和129名临床疑似迟发性胃排空障碍的患者在238 kcal餐后45、90、120、150、180和240分钟接受了100 mg [C-13]-S血小板和0.5 mCi Tc-99 m标记试验。我们用该试验餐、个体内和个体间变异系数（COVs）以及[C-13] GEBT呼气排出剂量百分比 *1000值确定了放射性造影的正常范围，以预测放射性造影半衰期并将GE分类为延迟、正常或加速。结果如下：在健康的情况下，服用这一餐后的第10次和第90次消化道造影GE半衰期分别为52和86分钟; 45分钟时，动脉造影和GEBT的个体内COV分别为31%和27%，90分钟时分别为17%和21%，120分钟时分别为13%和16%，150分钟时分别为10%和13%，180分钟时分别为8%和12%。[C-13] GEBT和动脉造影每次的个体间COV通常相似，比个体内COV低1%-4%。45、150和180分钟的个体呼吸样本可预测GE类别;在80%特异性下，45和180分钟样本组合识别加速GE的敏感性为93%，150和180分钟样本组合识别延迟GE的敏感性为89%。结论：[C-13]-S platensis GEBT的重现性与血小板造影术相同;两种试验的不精确性反映了生理变化。用4个呼吸样本，这种方法与现成的膳食是有效的，以评估GE在临床和研究中。
Background & Aims: The aim of this study was to validate a [C-13]-Spirulina platensis gastric emptying (GE) breath test (GEBT) with a standardized meal. Methods: Thirty-eight healthy volunteers and 129 patients with clinically suspected delayed GE underwent measurements at 45, 90, 120, 150, 180, and 240 minutes after a 238 kcal meal labeled test with 100 mg [C-13]-S platensis and 0.5 mCi Tc-99m. We established normal ranges for scintigraphy with this test meal, intraindividual and interindividual coefficients of variation (COVs), and the ability of the [C-13] GEBT breath percent dose excreted *1000 values to predict scintigraphic half-life and to categorize GE as delayed, normal, or accelerated. Results: In health, the 10th and 90th percentiles of half-life for scintigraphic GE with this meal were 52 and 86 minutes; intraindividual COVs for scintigraphy and the GEBT were, respectively, 31% and 27% at 45 minutes, 17% and 21% at 90 minutes, 13% and 16% at 120 minutes, 10% and 13% at 150 minutes, and 8% and 12% at 180 minutes. Interindividual COVs at each time for the [C-13] GEBT and scintigraphy were typically similar to 1%-4% lower than intraindividual COVs. Individual breath samples at 45, 150, and 180 minutes predicted GE category; at 80% specificity, 45- and 180-minute samples combined were 93% sensitive to identify accelerated GE, and 150- and 180-minute combined were 89% sensitive for delayed GE. Conclusion : [C-13]-S platensis GEBT is as reproducible as scintigraphy; imprecision with both tests reflects physiologic variation. With 4 breath samples, this method with an off-the-shelf meal is valid to assess GE in clinic and in research.