Horowitz Michael, Jones Karen L, Harding Philip E, Wishart Judith M
Department of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia.
Digestion. 2002;65(1):41-6. doi: 10.1159/000051930.
BACKGROUND/AIMS: The effect of erythromycin on gastric emptying is attenuated during hyperglycaemia. The aim of this study was to determine in patients with diabetic gastroparesis whether the effect of cisapride on gastric emptying of solids and liquids is influenced by the plasma glucose concentration.
Nineteen patients with type 1 diabetes mellitus, who had delayed gastric emptying of solids and/or liquids, were studied. On 2 separate days, each patient received cisapride (20 mg) or placebo orally 60 min before scintigraphic measurement of gastric emptying of a mixed solid (ground beef) and liquid (dextrose) meal. The plasma glucose concentrations were measured at -5, 30, 60, 90, and 120 min during each gastric emptying measurement.
Cisapride accelerated both solid (retention at 100 min 43 +/- 4 vs. 69 +/- 4%, p < 0.001) and liquid (T50 27 +/- 2 vs. 39 +/- 2 min, p < 0.001) gastric emptying. The mean plasma glucose level was not significantly different after placebo when compared with cisapride (19.5 +/- 1.1 vs. 18.2 +/- 1.0 mmol/l). The change in the 50% emptying time (T50) for liquid, but not solid, emptying was related (r = 0.55, p = 0.01) to the change in the plasma glucose AUC from 0 to 30 min between the placebo and cisapride tests, i.e., the acceleration was greater if the plasma glucose concentration was relatively less during the gastric emptying test performed on cisapride.
The effect of cisapride on gastric emptying, at least that of liquids, in patients with diabetic gastroparesis appears to be dependent on the plasma glucose concentration.
背景/目的：高血糖期间红霉素对胃排空的作用减弱。本研究旨在确定糖尿病胃轻瘫患者中，西沙必利对固体和液体胃排空的作用是否受血浆葡萄糖浓度影响。
对19例1型糖尿病且存在固体和/或液体胃排空延迟的患者进行研究。在2个不同日期，每位患者在通过闪烁扫描测量混合固体（绞碎牛肉）和液体（葡萄糖）餐的胃排空前60分钟口服西沙必利（20毫克）或安慰剂。在每次胃排空测量期间的-5、30、60、90和120分钟测量血浆葡萄糖浓度。
西沙必利加速了固体（100分钟时滞留率43±4% 对69±4%，p<0.001）和液体（T50 27±2分钟对39±2分钟，p<0.001）的胃排空。与西沙必利相比，安慰剂后平均血浆葡萄糖水平无显著差异（19.5±1.1对18.2±1.0毫摩尔/升）。液体而非固体排空的50%排空时间（T50）变化与安慰剂和西沙必利试验之间0至30分钟血浆葡萄糖AUC的变化相关（r = 0.55，p = 0.01），即如果在西沙必利进行的胃排空试验期间血浆葡萄糖浓度相对较低，加速作用更大。
西沙必利对糖尿病胃轻瘫患者胃排空的作用，至少对液体的作用，似乎取决于血浆葡萄糖浓度。
