Kojecky Vladimir, Dolina Jiri, Kianicka Bohuslav, Misurec Miroslav, Varga Michal, Latta Jiri, Vaculin Vladimir
Internal Clinic IPVZ, Bata Regional Hospital, Zlin, Czech Republic.
Dept. of Gastroenterology and Internal Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
J Gastrointestin Liver Dis. 2014 Jun;23(2):141-6. doi: 10.15403/jgld.2014.1121.232.vk1.
BACKGROUND & AIMS: To compare the efficacy and tolerance of sodium picosulphate/magnesium citrate (PMC) and polyethylene glycol (PEG) in a single or split dose regimen for colonoscopy bowel preparation.
A prospective, randomized, endoscopist-blinded, multicenter study. The patients were randomly assigned to receive PMC (PMC4/0) or PEG (PEG4/0) in a single dose 4L day before colonoscopy or a split dose 2+2L PMC (PMC2/2) or 3+1L PEG (PEG3/1) one day before and in the morning before the colonoscopy. Each patient was interviewed to determine his/her subjective tolerance of the preparation before the procedure. The quality of bowel cleansing was assessed in a blinded test performed by multiple endoscopists using the Aronchick scale.
A total of 600 patients were enrolled, 88.2% were included in the analysis. Satisfactory bowel cleansing (Aronchick score 1 and 2) was significantly more frequent when a split dose was used irrespective of the solution type (81.6% PMC2/2, 87.3% PEG3/1 vs. 73.0% PEG4/0, p = 0.024). In single dose regimens, PMC performed better than PEG (82.6% vs. 73.0%). Single or split dose PMC preparations were comparable. A PMC based solution was generally better tolerated than PEG regardless of the regimen used (p < 0.001). Nausea was reported mostly after the 4L PEG (32.8%, p < 0.001), incontinence after a split PMC dose (34.4%, p = 0.002), and bloating after the 4L PEG (38.0%, p < 0.001). There was no significant difference in the prevalence of vomiting.
Colonic preparation with PMC yields similar results as a split PEG dose, regardless of whether PMC is administered in single or separate doses. PMC is better tolerated than any PEG-based preparation. A single 4L PEG the day before the colonoscopy is less appropriate for bowel cleansing.
比较比沙可啶钠/柠檬酸镁（PMC）和聚乙二醇（PEG）在结肠镜检查肠道准备中的单剂量或分剂量方案的疗效和耐受性。
一项前瞻性、随机、内镜医师盲法、多中心研究。患者被随机分配在结肠镜检查前一天接受4L单剂量的PMC（PMC4/0）或PEG（PEG4/0），或在结肠镜检查前一天和当天上午分别接受2+2L分剂量的PMC（PMC2/2）或3+1L分剂量的PEG（PEG3/1）。在操作前对每位患者进行访谈，以确定其对准备工作的主观耐受性。由多名内镜医师使用阿隆奇克量表进行盲法测试，评估肠道清洁质量。
共纳入600例患者，88.2%纳入分析。无论溶液类型如何，使用分剂量时，满意的肠道清洁（阿隆奇克评分1和2）更为常见（PMC2/2为81.6%，PEG3/1为87.3%，而PEG4/0为73.0%，p=0.024）。在单剂量方案中，PMC的效果优于PEG（82.6%对73.0%）。单剂量或分剂量的PMC制剂效果相当。无论采用何种方案，基于PMC的溶液总体上比PEG耐受性更好（p<0.001）。恶心大多在服用4L PEG后出现（32.8%，p<0.001），分剂量的PMC后出现失禁（34.4%，p=0.002），4L PEG后出现腹胀（38.0%，p<0.001）。呕吐发生率无显著差异。
无论PMC是单剂量还是分剂量给药，使用PMC进行结肠准备与分剂量的PEG产生相似的结果。PMC的耐受性优于任何基于PEG的制剂。结肠镜检查前一天单次服用4L PEG不太适合肠道清洁。
