정상인에서 방사성비투과성 표지자를 이용한 위 배출 측정과 Erythromycin의 효과

Abstract

Background/Aims: The technique for measuring gastric emp.ying is variable. Scintigraphy is the standard technique. However, there are several disadvantages. The aims of this study were to develop a simple radiologic method for assessing gastric ernptying of an indigestible solid using radio-opaque rnarkers(ROM) and tc> investigate the effects of erythromycin on gastric emptying and plasma motilin level in postprandial state. Methods: After ovemight f'ast, subjects were randomized to receive either placebo or erythromycin lactobionate(Abbott, U.S.A.) 250rng per oral or intravenously in a single morning dose. A 300KCal standarclized test meal was also administed with one ROM capsule. A supine plain abdominal radiograph was taken 1, 2, 3 and 6 hours after ingestion of the test meal. The number of markers which were still in the stomach, on the X-ray picture, were counted to assess gastric clearance by two radiologist individually. Peripheral blood samples were obtained at 0, 0.5, 1, 1.5, 2, 3 and 6 hours af'ter ingestion of the test meal. Plasma motilin concentrations are determined with a commercial raclio-immunoassay kits(Motilin RIA kit, Peninsula, England). Results: The rate of gastric clearance v,ere 2.7% within J hour, 22.7% within 2 hours, 60.2% within 3 hours and 100.0% within 6 hours after ingestion of the markers with placebo. A half of markers was cleared within 3 hours in most subjects. Sing]e administration of erythromycin either orally or intravenously significantly accelerated gastric 'learance of ROM(p 0.05). Mean emptying of ROM averaged 25.4% within 1 hours, 82.3% within 2 hours, 98.5% within 3 hours and 100.0% within 6 hours after ingestion of the markers with erythromycin. But there was no significant difference in plasma motilin level between fasting,md fed status, and nor after administration of erythromycin. Conclusions: On the 1>asis of these results, ROM technique may be used as an easy, non-invasive screening test for the purpose of cletecting gastric motor clysfunction. And erythromycin accelerates gastric emptying of indigestible solid, independent of the plasma motilin concentration. (Korean J Gastroenteroll 1997; 30:148 - 155)