Franzese A, Borrelli O, Corrado G, Rea P, Di Nardo G, Grandinetti A L, Dito L, Cucchiara S
Department of Paediatrics, University of Naples 'Federico II', Naples, Italy.
Aliment Pharmacol Ther. 2002 May;16(5):951-7. doi: 10.1046/j.1365-2036.2002.01240.x.
Disorders of gastrointestinal motility are commonly detected in patients with insulin-dependent diabetes mellitus and are associated with significant morbidity. They contribute to poor metabolic control of diabetes.
To assess the effect of an 8-week course of domperidone or cisapride on gastric electrical activity, gastric emptying time and dyspeptic symptoms in children with insulin-dependent diabetes mellitus and gastroparesis.
Dyspeptic symptoms were assessed by a score system, gastric emptying time was measured by ultrasonography and gastric electrical activity was obtained by electrogastrography. Fourteen children received domperidone and 14 received cisapride. The median (range) ages were 11.6 years (5-15 years) and 12 years (6-16.9 years), respectively. Symptom assessment, ultrasonography and electrogastrography were repeated at the end of the trial. Fasting and fed (180 min after feeding) glycaemia and haemoglobin A, C (HbA1c) levels were also measured.
At the end of the trial both groups showed a significant decrease in symptomatic score; however, the score was markedly lower in the domperidone group than in the cisapride group (P < 0.01). Domperidone was significantly more effective than cisapride in reducing the gastric emptying time (P < 0.05), normalizing gastric electrical activity (P < 0.05) and decreasing the prevalence of episodes of gastric dysrhythmia (P < 0.01). Domperidone was also more effective than cisapride in improving diabetic metabolic control. No potentially drug-related adverse effects occurred.
In children with insulin-dependent diabetes mellitus complicated by dyspeptic symptoms and gastroparesis, domperidone is superior to cisapride in reversing gastric emptying delay and gastric electrical abnormalities, as well as in improving dyspeptic symptoms and diabetic metabolic control.
胃肠动力障碍在胰岛素依赖型糖尿病患者中常见，且与显著的发病率相关。它们导致糖尿病代谢控制不佳。
评估8周疗程的多潘立酮或西沙必利对胰岛素依赖型糖尿病合并胃轻瘫儿童的胃电活动、胃排空时间和消化不良症状的影响。
通过评分系统评估消化不良症状，用超声测量胃排空时间，通过胃电图获取胃电活动。14名儿童接受多潘立酮治疗，14名接受西沙必利治疗。年龄中位数（范围）分别为11.6岁（5 - 15岁）和12岁（6 - 16.9岁）。在试验结束时重复症状评估、超声检查和胃电图检查。还测量了空腹和进食后（进食180分钟后）血糖及糖化血红蛋白（HbA1c）水平。
试验结束时两组症状评分均显著降低；然而，多潘立酮组的评分明显低于西沙必利组（P < 0.01）。在缩短胃排空时间（P < 0.05）、使胃电活动正常化（P < 0.05）以及降低胃节律紊乱发作的发生率（P < 0.01）方面，多潘立酮比西沙必利显著更有效。在改善糖尿病代谢控制方面，多潘立酮也比西沙必利更有效。未发生潜在的药物相关不良反应。
在胰岛素依赖型糖尿病合并消化不良症状和胃轻瘫的儿童中，多潘立酮在逆转胃排空延迟和胃电异常、改善消化不良症状及糖尿病代谢控制方面优于西沙必利。
