尼扎替丁对健康受试者一过性下食管括约肌松弛（TLESRs）及酸反流的影响。

The effects of nizatidine on transient lower esophageal sphincter relaxations (TLESRs) and acid reflux in healthy subjects.

作者信息

Iwakiri Katsuhiko, Kawami Noriyuki, Sano Hirohito, Tanaka Yuriko, Umezawa Mariko, Futagami Seiji, Hoshihara Yoshio, Sakamoto Choitsu

机构信息

Department of Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan.

出版信息

J Smooth Muscle Res. 2011;47(6):157-66. doi: 10.1540/jsmr.47.157.

DOI:10.1540/jsmr.47.157

PMID:22374468

Abstract

BACKGROUND

A study in Japan has found that nizatidine (NIZ) is more effective than other histamine H2 receptor agonists (H2RAs) in treating reflux esophagitis (RE), although the NIZ group included a greater number of patients with severe RE. As there was no difference in the level of acid suppression among H2RAs, it is possible that NIZ has other effects on esophageal acid exposure (EAE) besides acid suppression. In this study, the effect of NIZ on transient lower esophageal sphincter relaxations (TLESRs) and acid reflux was evaluated in healthy subjects.

METHODS

In 10 healthy subjects, while in a sitting position, esophageal motility and a pH study were measured for 3 hours after a meal on 2 separate days at least 2 weeks apart. Participants received an oral dose of 150 mg of NIZ, 60 min before the meal on one day and a placebo on the other. Both studies were preceded by a week of treatment with either NIZ (150 mg, bid) or a placebo and the order of treatment was randomized.

RESULTS

Basal LES pressure in the NIZ group (14.1 mmHg, median) was significantly greater than that of the placebo group (8.5 mmHg). The rate of TLESRs in the NIZ group (22.0/3 h) for the postprandial 3-hour period was significantly less than that of the placebo group (16.5/3 h) and the rate of acid reflux during TLESRs (24.7%) and the EAE (0.2%) in the NIZ group for the postprandial 3-hour period was also significantly less than that of the placebo group (74.4% and 2.8%, respectively).

CONCLUSION

NIZ significantly reduces acid reflux by inhibiting both the rate of TLESRs and acid reflux during TLESRs.

摘要

背景

日本的一项研究发现，尽管尼扎替丁（NIZ）组中重度反流性食管炎（RE）患者数量较多，但在治疗反流性食管炎方面，尼扎替丁比其他组胺H2受体激动剂（H2RAs）更有效。由于H2RAs之间的抑酸水平没有差异，因此尼扎替丁除了抑酸作用外，可能对食管酸暴露（EAE）还有其他影响。在本研究中，评估了尼扎替丁对健康受试者一过性下食管括约肌松弛（TLESRs）和酸反流的影响。

方法

10名健康受试者在至少相隔2周的2个不同日子里，于饭后坐位时进行3小时的食管动力和pH值研究。受试者在其中一天进餐前60分钟口服150毫克尼扎替丁，另一天口服安慰剂。两项研究之前均先进行一周的尼扎替丁（150毫克，每日两次）或安慰剂治疗，治疗顺序随机。

结果

尼扎替丁组的基础下食管括约肌压力（中位数为14.1毫米汞柱）显著高于安慰剂组（8.5毫米汞柱）。尼扎替丁组餐后3小时的TLESRs发生率（22.0/3小时）显著低于安慰剂组（16.5/3小时），尼扎替丁组餐后3小时TLESRs期间的酸反流发生率（24.7%）和EAE发生率（0.2%）也显著低于安慰剂组（分别为74.4%和2.8%）。