Lobo Beatriz, Serra Jordi, D'Amato Massimo, Rovati Lucio, Malagelada Juan-R, Santos Javier, Azpiroz Fernando
Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.
J Gastroenterol Hepatol. 2016 Feb;31(2):288-93. doi: 10.1111/jgh.13177.
Participants with functional gut disorders develop gas retention and symptoms in response to intestinal gas loads that are well tolerated by healthy subjects. To determine the role of cholecystokinin (CCK1 ) receptors on gas transit and tolerance in women with functional gut disorders.
In 12 healthy women, and 24 women with functional gut disorders (12 dyspepsia and 12 constipation-predominant irritable bowel syndrome) gas was infused into the jejunum at 12 mL/min for 3 h with simultaneous duodenal lipid infusion (intralipid 1 kcal/min), while measuring anal gas evacuation and abdominal symptoms on a 0-6 score scale. Triple-blind paired studies during iv infusion of dexloxiglumide (2.5 mg/kg bolus plus 5 mg/kg h continuous infusion), a selective CCK1 inhibitor, or saline (control) were performed in random order.
During saline infusion participants with functional gut disorders developed significantly greater gas retention and abdominal symptoms than healthy subjects (394 ± 40 mL vs 265 ± 35 mL and 2.8 ± 0.3 vs 1.9 ± 0.4 highest abdominal symptom score, respectively; P < 0.05 for both). Dexloxiglumide increased gas retention in both groups (514 ± 35 mL and 439 ± 60 mL, respectively; P = 0.033 vs saline for both); however, despite the larger retention, dexloxiglumide reduced abdominal symptoms (2.3 ± 0.2 score and 0.8 ± 0.3 score, respectively; P = 0.05 vs saline for both). Post-hoc analysis showed that, the decrease in abdominal symptoms was more pronounced in those participants with functional gut disorders with higher basal abdominal symptoms than in the rest (P = 0.037).
Inhibition of CCK1 receptors by dexloxiglumide increases intestinal gas retention and reduces abdominal symptoms in response to by intestinal gas loads. European Clinical Trials Database (EudraCT 2005-003338-16).
功能性肠道疾病患者在面对健康受试者能够良好耐受的肠道气体负荷时，会出现气体潴留和症状。为了确定胆囊收缩素（CCK1）受体在功能性肠道疾病女性患者气体转运和耐受性中的作用。
对12名健康女性和24名功能性肠道疾病女性患者（12名消化不良患者和12名以便秘为主的肠易激综合征患者），以12毫升/分钟的速度向空肠内注入气体3小时，同时向十二指肠注入脂质（1千卡/分钟的英脱利匹特），同时以0至6分的评分标准测量肛门排气和腹部症状。在静脉输注选择性CCK1抑制剂地洛西呱胺（2.5毫克/千克推注加5毫克/千克/小时持续输注）或生理盐水（对照）期间，进行三盲配对研究，研究顺序随机。
在输注生理盐水期间，功能性肠道疾病患者的气体潴留和腹部症状明显比健康受试者严重（分别为394±40毫升对265±35毫升，最高腹部症状评分2.8±0.3对1.9±0.4；两者P均<0.05）。地洛西呱胺使两组的气体潴留增加（分别为514±35毫升和439±60毫升；两者与生理盐水相比P=0.033）；然而，尽管潴留量更大，但地洛西呱胺减轻了腹部症状（分别为2.3±0.2分和0.8±0.3分；两者与生理盐水相比P=0.05）。事后分析表明，基础腹部症状较高的功能性肠道疾病患者腹部症状的减轻比其余患者更明显（P=0.037）。
地洛西呱胺抑制CCK1受体会增加肠道气体潴留，并减轻肠道气体负荷引起的腹部症状。欧洲临床试验数据库（EudraCT 2005-003338-16）。
