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关于不同药物对Oddi括约肌作用的胆管镜测压法

Choledochoscope manometry about different drugs on the Sphincter of Oddi.

作者信息

Kong Jing, Wu Shuo-Dong, Zhang Xiao-Bo, Li Zhen-Sheng, Shi Gang, Wang Wei, Chen Jun-Zhi

机构信息

Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

出版信息

World J Gastroenterol. 2008 Oct 14;14(38):5907-12. doi: 10.3748/wjg.14.5907.

Abstract

AIM

To assess the effects of H(2)-receptor blocking pharmacon, protease inhibitor, and gastro kinetic agents on the human Sphincter of Oddi (SO) motility by choledochoscope manometry.

METHODS

One hundred and seventy-five patients with T tube installed after cholecystectomy and choledochotomy were assessed by choledochoscope manometry. They were randomly assigned into groups of H(2)-receptor blocking pharmacon, protease inhibitor, and gastro kinetic agents. The Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duodenal pressure (DP), and common bile duct pressure (CBDP) were scored and analyzed.

RESULTS

SOBP and SOCA were significantly decreased after cimetidine administration, and no statistical difference was seen in the famotidine group. In the gabexate mesilate group, SOBP had decreased significantly. In the ulinastatin group, SOCA decreased when ulinastatin was given at the rate of 2500 U/min; when ulinastatin administration was raised to 5000 U/min, SOBP, SOF and SOCA all experienced a fall. SOBP and SOCA for domperidone and SOCA for mosapride groups all decreased distinctly after administration.

CONCLUSION

The regular dosage of cimetidine showed an inhibitory effect on the motility of SO, while famotidine had no obvious effects otherwise. Gabnexata mesilate, ulinastatin and gastro kinetic agents also showed inhibitory effects on the SO motility.

摘要

目的

通过胆管镜测压评估H₂受体阻滞剂、蛋白酶抑制剂和胃肠动力药对人Oddi括约肌(SO)运动的影响。

方法

对175例胆囊切除及胆总管切开术后留置T管的患者进行胆管镜测压评估。将他们随机分为H₂受体阻滞剂组、蛋白酶抑制剂组和胃肠动力药组。对Oddi括约肌基础压力(SOBP)、幅度(SOCA)、收缩频率(SOF)、十二指肠压力(DP)和胆总管压力(CBDP)进行评分并分析。

结果

西咪替丁给药后SOBP和SOCA显著降低,法莫替丁组未见统计学差异。在甲磺酸加贝酯组,SOBP显著降低。在乌司他丁组,以2500 U/min的速率给予乌司他丁时SOCA降低;当乌司他丁给药速率提高到5000 U/min时,SOBP、SOF和SOCA均下降。多潘立酮组的SOBP和SOCA以及莫沙必利组的SOCA给药后均明显降低。

结论

常规剂量的西咪替丁对SO运动有抑制作用,而法莫替丁无明显影响。甲磺酸加贝酯、乌司他丁和胃肠动力药对SO运动也有抑制作用。

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