Yamada M, Hongo M, Okuno Y, Nishimura N, Ueno M, Kawakami H, Toyota T
Third Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
J Smooth Muscle Res. 1992 Aug;28(4):153-8. doi: 10.1540/jsmr.28.153.
Delayed gastric emptying in diabetic patients occurs with progress of automatic neuropathy as one late complication. Delayed emptying is deeply correlated with poor glycemic control, due to imbalance between nutrients absorption and effect of exogenous insulin. AS-4370 is a newly developed prokinetic agent which has been reported to selectively activate motility of the upper gastrointestinal tract through enhancing acetylcholine release from nerve terminals within the enteric mural plexus. In this study, we evaluated the effect of AS-4370 on gastric motility in diabetic patients with autonomic neuropathy. Eight diabetic patients with autonomic neuropathy (3 males and 5 females) with mean age of 56 years old (range 29-66) participated to this study after giving written informed consent. Gastric motility was evaluated by gastric emptying and electrogastrography. Gastric emptying study was done using 99mTc-Tin colloid labeled omelet meal served with 2 slices of toast and 200 ml of milk. Electrogastrography was recorded from epigastric skin surface, for 30 minutes before and after meal each. AS-4370, 7.5 mg tid, was given for four weeks after basal recording of gastric motility studies. Following the 4-week treatment with AS-4370, gastric motility studies were repeated. For the motility studies after medication, drug was given 30 minutes before test meal. Gastric retention rate at 150 minutes in all patients were over 45% of upper limit of normal range in basal study with mean value of 69 +/- 5%, which decreased significantly to 52 +/- 5%, with AS-4370 treatment (p < 0.01). Gastric emptying speed, another parameter for gastric emptying also improved with medication.(ABSTRACT TRUNCATED AT 250 WORDS)
糖尿病患者胃排空延迟是自主神经病变进展过程中出现的一种晚期并发症。由于营养物质吸收与外源性胰岛素作用之间的失衡，胃排空延迟与血糖控制不佳密切相关。AS - 4370是一种新开发的促动力剂，据报道它可通过增强肠壁神经丛内神经末梢乙酰胆碱的释放来选择性激活上消化道的蠕动。在本研究中，我们评估了AS - 4370对患有自主神经病变的糖尿病患者胃动力的影响。8名患有自主神经病变的糖尿病患者（3名男性和5名女性），平均年龄56岁（范围29 - 66岁），在签署书面知情同意书后参与了本研究。通过胃排空和胃电图评估胃动力。胃排空研究使用99mTc - 锡胶体标记的煎蛋餐，配有2片烤面包和200毫升牛奶。在餐前和餐后各30分钟从上腹部皮肤表面记录胃电图。在基础胃动力研究记录后，给予AS - 4370，7.5毫克，每日三次，持续四周。在使用AS - 4370进行4周治疗后，重复胃动力研究。对于用药后的动力研究，在试验餐30分钟前给药。在基础研究中，所有患者150分钟时的胃潴留率超过正常范围上限的45%，平均值为69±5%，经AS - 4370治疗后显著降至52±5%（p < 0.01）。胃排空速度这一胃排空的另一个参数用药后也有所改善。（摘要截短至250字）
