Author |
정병천(Byung Chun Chung),최정일(Chung Il Choi),곽동석(Dong Suck Gwak),이재태(Jae Tae Lee),이규보(Kyu Bo Lee),김보완(Bo Wan Kim),정준모(Jun Mo Chung), |
Abstract |
Gastic emptying scan in diabetic patients is widely
used to assess the degree of motility disturbance and
the symtoms such as nausea, vomiting, bloating,
abdominal pain and early gastric fullness which we
can't find anatomic lesion by fiberoscopic or barium
study. In order to determine the relationship among
diabetic gastropathy, neropathy, retinopathy and
disease duration, gastric emptying scan using Tc-99m-
tin colloid labeled scramble egg in hamburger was
performed in 10 healty male controls and 50 diabetic
patients which were subdivided to no neuropathy,
peripheral neuropathy and autonomic neuropathy groups
according to the degree of diabetic neuropathy and no
retinopathy, background retinopathy and proliferative
retinopathy groups according to the degree of diabetic
retinopathy. After medication of cisapride for 2 weeks,
we observed the presence of improvement of gastric
motility in diabetics. The results were as following:
1) In controls, gastric emptying time (GET1/2) was
75¡¾13.6 min and 2 hour gastric retension rate(GRR2)
was 32¡¾11.1%. 2) In diabetics, GET/2 was prolonged
more than 2 hours and GRR2 was 58¡¾23.1%. According
to degree of neuropathy, GET1/2 was prolonged more than
2 hours in all three groups and GRR2 was 54¡¾24.1% in
no neuropathy group, 57¡¾24.3% in peripheral
neuropathy group and 69¡¾24.6% in autanomic
neuropathy group. According to degree of retinopathy,
GET1/2 was 110¡¾23.4 min in no retinopathy group and
prolonged more than 2 hours in other two groups and
GRR2 was 45¡¾21.6% in no retinopathy group,
71¡¾19.7% in background retinopathy group and
73¡¾21.5% in proliferative retinopathy group. 3)
After cisapride for 2 weeks, GET1/2 and GRR2 were
improved as 90¡¾14.6 min and 40¡¾13.8% (initial
GET1/2 and GRR2 were above 2 hours and 61¡¾15.4%). We
can conclude from above findings that gastropathy in
diabetic neuropathy suggesting main underlying factor
in motility disorder. The degree of retinopathy and
disease duration were correlated with severity of
gastropathy in diabetics. From the results of gastric
emptying scan, we can conclude that cisapride was
useful drug for improving diabetic gastropathy and
gastric emptying scan was valuable for assessing
severity of diabetic gastropathy as non-invasive
method. |