西沙必利可改善胆结石患者的胆囊排空及胆汁脂质成分。

Cisapride improves gallbladder emptying and bile lipid composition in patients with gallstones.

作者信息

Dhiman R K, Reddi R, Sharma A, Singh R, Kohli K K, Gupta S, Suri S, Chawla Y

机构信息

Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Gastroenterol Hepatol. 2001 Jul;16(7):816-20. doi: 10.1046/j.1440-1746.2001.02518.x.

DOI:10.1046/j.1440-1746.2001.02518.x

PMID:11446892

Abstract

BACKGROUND AND AIM

Biliary cholesterol supersaturation, gallbladder stasis and delayed intestinal transit are the key events in cholesterol gallstone formation. We studied the effect of cisapride, a prokinetic drug, on gallbladder emptying and bile composition in patients with gallstone disease undergoing cholecystectomy.

METHODS

Gallbladder emptying, cholesterol saturation index (CSI) and nucleation time were studied in 21 patients with gallstone disease. Eleven patients (cisapride group, age 41.9 +/- 2.9 years) received tablet cisapride 10 mg t.i.d. for 2 weeks, while 10 patients (placebo group, age 42.1 +/- 1.9 years) received placebo for the same duration. Gallbladder emptying was repeated in all patients after a 2-week treatment with cisapride or placebo. Gallbladder bile was obtained at the time of surgery for the measurement of CSI and nucleation time.

RESULTS

Residual volume of the gallbladder decreased (mean +/- SE, 18.6 +/- 2.5 mL vs 10.0 +/- 1.1 mL, P = 0.007), and the ejection fraction increased (43.5 +/- 5.3% vs 60.0 +/- 3.2%, P = 0.007) in patients in the cisapride group, while no change was observed in placebo group patients. Nucleation time was higher in the cisapride group than in the placebo group (14.9 +/- 1.3 days vs 8.0 +/- 0.9 days, P = 0.003). Patients in the cisapride group had a significantly lower cholesterol concentration (molar percentage, 5.1 +/- 0.3% vs 6.8 +/- 0.8%, P = 0.049) and CSI (1.0 +/- 0.1 vs 1.36 +/- 0.11, P = 0.034) than patients in the placebo group.

CONCLUSION

Cisapride improves gallbladder emptying and bile lithogenicity in patients with gallstone disease.

摘要

背景与目的

胆汁胆固醇过饱和、胆囊淤滞和肠道转运延迟是胆固醇结石形成的关键因素。我们研究了促动力药物西沙必利对接受胆囊切除术的胆结石病患者胆囊排空和胆汁成分的影响。

方法

对21例胆结石病患者进行胆囊排空、胆固醇饱和指数（CSI）和成核时间的研究。11例患者（西沙必利组，年龄41.9±2.9岁）口服西沙必利片10 mg，每日3次，共2周；10例患者（安慰剂组，年龄42.1±1.9岁）服用相同疗程的安慰剂。在接受西沙必利或安慰剂治疗2周后，所有患者再次进行胆囊排空检查。手术时获取胆囊胆汁，用于测量CSI和成核时间。

结果

西沙必利组患者胆囊残余容积减少（均值±标准误，18.6±2.5 ml对10.0±1.1 ml，P = 0.007），射血分数增加（43.5±5.3%对60.0±3.2%，P = 0.007），而安慰剂组患者未观察到变化。西沙必利组的成核时间高于安慰剂组（14.9±1.3天对8.0±0.9天，P = 0.003）。西沙必利组患者的胆固醇浓度（摩尔百分比，5.1±0.3%对6.8±0.8%，P = 0.049）和CSI（1.0±0.1对1.36±0.11，P = 0.034）显著低于安慰剂组患者。