Sarna S K, Soergel K H, Koch T R, Stone J E, Wood C M, Ryan R P, Arndorfer R C, Cavanaugh J H, Nellans H N, Lee M B
Department of Surgery, Medical College of Wisconsin, Milwaukee.
Gastroenterology. 1991 Dec;101(6):1488-96. doi: 10.1016/0016-5085(91)90383-v.
The effects of an antibacterially effective IV dose of erythromycin on gastrointestinal motor activity were investigated in eight normal healthy human volunteers in the fasted state and the fed state. Motor activity was recorded by a multilumen manometric tube. Data were analyzed visually and by a computer method. Blood samples were obtained for erythromycin and motilin assays. In the gastric antrum, erythromycin significantly increased the total duration, amplitude, and area under contractions from 0 to 60 minutes and frequency of contractions from 0 to 30 minutes from the start of its infusion in the fasted state. A similar response in the fed state occurred mostly from 0 to 30 minutes after the start of erythromycin infusion. By contrast, erythromycin inhibited the frequency and decreased the duration of small intestinal contractions in the fed state but had no effect in the fasted state. The gastric motor response was related to the plasma concentration of erythromycin, but not to plasma motilin. Erythromycin significantly shortened the duration of migrating motor complex disruption by a meal. Erythromycin also induced symptoms of upper abdominal pain, bloating, and nausea. Abdominal pain was related to strong antral contractions in both fasted and fed states; bloating occurred only in the fed state. Nausea occurred in both fasted and fed states, but it was not related to any specific pattern of motor activity. It is concluded that the strong antral contractions induced by erythromycin may accelerate the rate of gastric emptying, but they may also be responsible for causing the sensations of upper abdominal pain and bloating. The motor response to erythromycin is less during the fed than during the fasted state. The strong antral contractions induced by erythromycin are not mediated by the release of motilin.
在8名处于空腹和进食状态的正常健康志愿者中，研究了静脉注射有效抗菌剂量的红霉素对胃肠运动活性的影响。通过多腔测压管记录运动活性。数据通过视觉和计算机方法进行分析。采集血样用于红霉素和胃动素检测。在胃窦部，在空腹状态下，从输注红霉素开始0至60分钟，红霉素显著增加收缩的总持续时间、幅度和收缩面积，以及0至30分钟的收缩频率。在进食状态下，类似的反应大多发生在输注红霉素开始后的0至30分钟。相比之下，红霉素在进食状态下抑制小肠收缩频率并缩短其持续时间，但在空腹状态下无此作用。胃运动反应与红霉素的血浆浓度有关，而与血浆胃动素无关。红霉素显著缩短了进餐对移行性运动复合波的破坏持续时间。红霉素还诱发上腹部疼痛、腹胀和恶心症状。在空腹和进食状态下，腹痛均与强烈的胃窦收缩有关；腹胀仅发生在进食状态。恶心在空腹和进食状态下均有发生，但与任何特定的运动活性模式无关。结论是，红霉素诱导的强烈胃窦收缩可能会加快胃排空速度，但也可能是导致上腹部疼痛和腹胀感觉的原因。进食状态下对红霉素的运动反应比空腹状态下小。红霉素诱导的强烈胃窦收缩不是由胃动素释放介导的。
