Ljutić Dragan, Perković Dijana, Rumboldt Zvonko, Bagatin Jugoslav, Hozo Izet, Pivac Nediljko
Department of Internal Medicine, Clinical Hospital, Split, Croatia.
Kidney Blood Press Res. 2002;25(1):61-4. doi: 10.1159/000049437.
Nausea and vomiting are well-known gastrointestinal complications in chronic renal failure and are frequent indications for the commencement of dialysis. Although the administration of antiemetic drugs (metoclopramide and, recently, ondansetron) is usually mentioned, there are scanty data on their effects.
A double-blind crossover study was done in 10 uremic patients. All the patients were uremic and suffered from nausea and vomiting. The drugs were randomly administered intravenously (either metoclopramide 10 mg or ondansetron 8 mg) 2 h after blood drawing for laboratory tests either on the 1st or on the 3rd study day at the same time. The outcomes were scored after 24 h of follow-up by (1) one of us (D.P.; 1-3 points: 1 = no effect; 2 = moderate effect - decreased frequency of vomiting, and 3 = good effect - no vomiting), and (2) by the patients (1-5 points).
The results obtained showed that ondansetron was more effective in controlling nausea and vomiting than metoclopramide, either objectively (2.80 +/- 0.422 vs. 1.40 +/- 0.699, p < 0.005) or subjectively (4.10 +/- 0.738 vs. 2.10 +/- 0.994, p < 0.005).
We conclude that at the dosage level studied ondansetron is about twice as effective as metoclopramide in the symptomatic relief of uremia-induced nausea and vomiting.
恶心和呕吐是慢性肾衰竭中众所周知的胃肠道并发症，也是开始透析的常见指征。尽管通常会提及使用止吐药物（甲氧氯普胺以及最近的昂丹司琼），但其效果的数据却很少。
对10名尿毒症患者进行了一项双盲交叉研究。所有患者均为尿毒症患者，且患有恶心和呕吐。在第1天或第3天进行实验室检查采血2小时后，随机静脉注射药物（要么是10毫克甲氧氯普胺，要么是8毫克昂丹司琼），且时间相同。在随访24小时后，由我们其中一人（D.P.；1 - 3分：1 = 无效果；2 = 中度效果 - 呕吐频率降低；3 = 良好效果 - 无呕吐）以及患者（1 - 5分）对结果进行评分。
所获得的结果表明，无论是客观上（2.80±0.422对1.40±0.699，p < 0.005）还是主观上（4.10±0.738对2.10±0.994，p < 0.005），昂丹司琼在控制恶心和呕吐方面比甲氧氯普胺更有效。
我们得出结论，在所研究的剂量水平下，昂丹司琼在缓解尿毒症引起的恶心和呕吐症状方面的效果约为甲氧氯普胺的两倍。
