Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, G3/310 CSC MC 3252, Madison, WI 53792-3252, USA.
Radiology. 2010 Jan;254(1):138-44. doi: 10.1148/radiol.09090398.
To compare colonic cleansing and fluid retention of double-dose magnesium citrate with those of single-dose sodium phosphate in patients undergoing computed tomographic (CT) colonography.
This retrospective HIPAA-compliant clinical study had institutional review board approval; informed consent was waived. The study included 118 consecutive patients given single-dose sodium phosphate for bowel catharsis and 115 consecutive patients at risk for phosphate nephropathy, who were instead given double-dose magnesium citrate. The bowel preparation regimen was otherwise identical. Four-point scales were used to assess residual stool and fluid in the six colonic segments, and attenuation of residual fluid was measured. An a priori power analysis was performed, and unpaired t tests with Welch correction were used to compare the two groups on stool and fluid scores and fluid attenuation.
Both cathartic regimens offered excellent colon cleansing, with no significant difference for residual stool in any of the six segments. Stool scores of 1 or 2 (ie, no residual stool or residual stool <5 mm) were recorded in 88.6% (627 of 708) of colonic segments in the sodium phosphate group and in 88.1% (608 of 690) in the magnesium citrate group. No clinically important differences were seen in residual fluid scores in any of the six segments, with the only significant difference seen in the sigmoid colon (2.17 for sodium phosphate vs 2.44 for magnesium citrate; P< 0.01). Fluid attenuation was significantly different between magnesium citrate and sodium phosphate groups (790 HU +/- 216 vs 978 HU +/- 160; P <.001).
Both sodium phosphate and magnesium citrate provided excellent colon cleansing for CT colonography. Residual stool and fluid were similar in both groups, and fluid attenuation values were closer to optimal in the magnesium citrate group. Since bowel preparation provided by both cathartics was comparable, magnesium citrate should be considered for CT colonography, particularly in patients at risk for phosphate nephropathy.
比较 CT 结肠成像中双剂量柠檬酸镁与单剂量磷酸钠对结肠清洁和液体潴留的影响。
这是一项回顾性 HIPAA 合规临床研究，获得了机构审查委员会的批准；豁免了知情同意。该研究纳入了 118 例接受单剂量磷酸钠进行肠道冲洗的连续患者和 115 例有发生磷酸肾毒性风险的连续患者，这些患者改用双剂量柠檬酸镁。两种方案的肠道准备方案是相同的。使用 4 分制评估 6 个结肠段的残留粪便和液体，并测量残留液体的衰减。进行了预先的功效分析，采用配对 t 检验和 Welch 校正比较两组粪便和液体评分及液体衰减值。
两种泻药方案均提供了出色的结肠清洁效果，在任何 6 个结肠段均无残留粪便的显著差异。磷酸钠组 708 个结肠段中有 88.6%（627 个）和柠檬酸镁组 690 个结肠段中有 88.1%（608 个）记录到粪便评分 1 或 2（即无残留粪便或残留粪便<5mm）。在任何 6 个结肠段的残留液体评分中均未观察到有临床意义的差异，仅在乙状结肠中观察到显著差异（磷酸钠为 2.17，柠檬酸镁为 2.44；P<0.01）。柠檬酸镁组与磷酸钠组之间的液体衰减值存在显著差异（790 HU +/- 216 与 978 HU +/- 160；P<.001）。
磷酸钠和柠檬酸镁均为 CT 结肠成像提供了出色的结肠清洁效果。两组的残留粪便和液体相似，柠檬酸镁组的液体衰减值更接近最佳。由于两种泻药的肠道准备效果相当，柠檬酸镁应考虑用于 CT 结肠成像，特别是在有发生磷酸肾毒性风险的患者中。
