Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2011 Feb;23(2):e32-9. doi: 10.1111/j.1365-2982.2010.01613.x. Epub 2010 Oct 27.
Abnormalities in gastric sensorimotor function (hypersensitivity to distention and impaired meal accommodation) have been implicated in the pathophysiology of functional dyspepsia (FD). To study the effect of the 5-HT(4) agonist tegaserod on sensitivity to gastric distention and gastric accommodation in FD.
Thirty FD patients (7 males, mean age 42 ± 2 years) underwent a gastric barostat study on two separate occasions, 2 weeks apart, after 5 days of pretreatment with placebo or tegaserod 6 mg b.i.d. in a double-blind randomized order. After introduction of the barostat bag, graded isobaric distentions (2 mmHg increments/2 min) were performed to determine gastric compliance and sensitivity to distention. Subsequently, the pressure level was set at intra-abdominal pressure [minimal distending pressure (MDP)] + 2 mmHg for 90 min, with administration of a liquid meal (200 mL; 300 kcal) after 30 min.
Tegaserod had no influence on MDP (7.9 ± 0.4 vs 7.4 ± 0.4 mmHg) or fasting gastric compliance (44 ± 10 vs 61 ± 6 mL mmHg(-1)) and on fasting thresholds for first perception (3.6 ± 0.4 vs 4.2 ± 0.2 mmHg above MDP) or discomfort (9.9 ± 0.7 vs 10.5 ± 0.5 mmHg above MDP). Tegaserod did not alter intra-balloon volumes before and after the meal [respectively 146 ± 14 vs 120 ± 11 and 297 ± 28 vs 283 ± 29 mL, not significant (NS)], or the amplitude of the meal-induced gastric relaxation (151 ± 23 vs 162 ± 23 mL, NS). In the subgroup with normal gastric emptying (n = 22), tegaserod significantly enhanced meal-induced accommodation (126 ± 23 vs 175 ± 29 mL, ANOVA P < 0.001).
CONCLUSIONS & INFERENCES: Tegaserod does not alter gastric sensorimotor function in FD patients as a group. In the subgroup with normal gastric emptying, tegaserod 6 mg b.i.d enhanced gastric accommodation.
胃感觉运动功能异常（对扩张的高敏感性和进食后胃容纳能力受损）与功能性消化不良（FD）的病理生理学有关。本研究旨在探讨 5-HT4 激动剂替扎色罗对 FD 患者胃扩张和胃容纳能力的影响。
30 例 FD 患者（男 7 例，平均年龄 42±2 岁）在 2 周内分别接受两次胃测压检查，两次检查前 5 天分别接受安慰剂或替扎色罗 6mg bid 治疗，采用双盲随机顺序。在引入测压袋后，以 2mmHg 为一档进行等容膨胀（每 2 分钟增加 2mmHg），以确定胃顺应性和对扩张的敏感性。随后，将压力水平设定为腹腔内压（最小膨胀压（MDP））+2mmHg，持续 90min，在 30min 时给予 200ml（300 千卡）液体餐。
替扎色罗对 MDP（7.9±0.4 与 7.4±0.4mmHg）或空腹胃顺应性（44±10 与 61±6mLmmHg(-1))以及空腹时的感知（3.6±0.4 与 MDP 以上 4.2±0.2mmHg）或不适阈值（9.9±0.7 与 MDP 以上 10.5±0.5mmHg）均无影响。替扎色罗也未改变餐前和餐后球内体积[分别为 146±14 与 120±11 和 297±28 与 283±29mL，无显著差异（NS）]或餐后胃松弛的幅度（151±23 与 162±23mL，NS）。在胃排空正常的亚组（n=22）中，替扎色罗显著增强了餐后胃容纳能力（126±23 与 175±29mL，ANOVA P<0.001）。
替扎色罗不能改变 FD 患者的胃感觉运动功能。在胃排空正常的亚组中，替扎色罗 6mg bid 增强了胃的容纳能力。
