Annese V, Janssens J, Vantrappen G, Tack J, Peeters T L, Willemse P, Van Cutsem E
Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Belgium.
Gastroenterology. 1992 Mar;102(3):823-8. doi: 10.1016/0016-5085(92)90164-t.
Erythromycin has been shown to act as a motilin agonist by binding to motilin receptors on gastrointestinal smooth muscle and to improve the severely impaired gastric emptying in patients with diabetic gastroparesis. To elucidate the motor pattern that accounts for this accelerated emptying, the effect of 200 mg erythromycin vs. placebo on postprandial motility of the stomach and the upper small intestine was examined in 13 normal subjects. Erythromycin significantly increased the amplitude of the antral contractions during the 2-hour postprandial study period (maximal difference in mean amplitude of distal antral contractions between erythromycin and placebo recorded from 80 to 90 minutes after meal: 123 +/- 17 vs. 44 +/- 12 mm Hg; P less than 0.005). The total number of antral contractions was not affected, but the contractions could be recorded manometrically higher up in the stomach after erythromycin than after placebo (9-12 vs. 3-6 cm above the pylorus). Antroduodenal coordination was significantly improved during the first postprandial hour, and the first normal phase 3 of the migrating motor complex, indicating the reappearance of fasting motility, occurred earlier after erythromycin than after placebo (128.3 +/- 14.3 vs. 173.4 +/- 16.1 minutes; P less than 0.05). These changes in postprandial motility induced by erythromycin may well account for its accelerating effect on gastric emptying.
红霉素已被证明可通过与胃肠道平滑肌上的胃动素受体结合而充当胃动素激动剂，并改善糖尿病胃轻瘫患者严重受损的胃排空。为了阐明导致这种加速排空的运动模式，在13名正常受试者中研究了200毫克红霉素与安慰剂对胃和上小肠餐后运动的影响。在餐后2小时的研究期间，红霉素显著增加了胃窦收缩的幅度（餐后80至90分钟记录的红霉素与安慰剂之间远端胃窦收缩平均幅度的最大差异：123±17 vs. 44±12毫米汞柱；P<0.005）。胃窦收缩的总数未受影响，但与安慰剂相比，服用红霉素后在胃中更高位置可通过测压记录到收缩（幽门上方9 - 12厘米 vs. 3 - 6厘米）。在餐后第一小时，胃十二指肠协调性显著改善，并且移行运动复合波的第一个正常3期（表明空腹运动重新出现）在服用红霉素后比服用安慰剂后出现得更早（128.3±14.3 vs. 173.4±16.1分钟；P<0.05）。红霉素引起的餐后运动这些变化很可能解释了其对胃排空的加速作用。
