Matsuura Mizue, Inamori Masahiko, Inou Yumi, Kanoshima Kenji, Higurashi Takuma, Ohkubo Hidenori, Iida Hiroshi, Endo Hiroki, Nonaka Takashi, Kusakabe Akihiko, Maeda Shin, Nakajima Atsushi
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine.
Office of Postgraduate Medical Education, Yokohama City University Hospital.
Endosc Int Open. 2017 Jun;5(6):E424-E429. doi: 10.1055/s-0043-105487. Epub 2017 May 31.
Lubiprostone has been reported to be an anti-constipation drug. The aim of the study was to investigate the usefulness of lubiprostone both for bowel preparation and as a propulsive agent in small bowel endoscopy.
This was a double-blind, placebo-controlled, 2-way crossover study of subjects who volunteered to undergo capsule endoscopy (CE). A total of 20 subjects (16 male and 4 female volunteers) were randomly assigned to receive a 24-μg tablet of lubiprostone 120 minutes prior to capsule ingestion for CE (L regimen), or a placebo tablet 120 minutes prior to capsule ingestion for CE (P regimen). Main outcome was gastric transit time (GTT) and small-bowel transit time (SBTT). Secondary outcome was adequacy of small-bowel cleansing and the fluid score in the small bowel. The quality of the capsule endoscopic images and fluid in the small bowel were assessed on 5-point scale.
The capsule passed into the small bowel in all cases. Median GTT was 57.3 (3 - 221) minutes for the P regimen and 61.3 (10 - 218) minutes for the L regimen ( = 0.836). Median SBTT was 245.0 (164 - 353) minutes for the P regimen and 228.05 (116 - 502) minutes for the L regimen ( = 0.501). The image quality score in the small bowel was 3.05 ± 1.08 for the P regimen and 3.80 ± 0.49 for the L regimen ( < 0.001). The fluid score in the small bowel was 2.04 ± 1.58 for the P regimen and 2.72 ± 1.43 for the L regimen ( < 0.001). There was a significant difference between the 2 regimens with regard to image quality. The fluid score was more plentiful for the L regimen than for the P regimen. There were no cases of capsule retention or serious adverse events in this study.
Our study showed that use of lubiprostone prior to CE significantly improved visualization of the small bowel during CE as a result of inducing fluid secretion into the small bowel.
据报道，鲁比前列酮是一种治疗便秘的药物。本研究的目的是探讨鲁比前列酮在小肠内镜检查肠道准备及作为推进剂方面的有效性。
这是一项针对自愿接受胶囊内镜检查（CE）的受试者的双盲、安慰剂对照、双向交叉研究。共有20名受试者（16名男性和4名女性志愿者）被随机分配，在摄入用于CE的胶囊前120分钟服用24μg鲁比前列酮片（L方案），或在摄入用于CE的胶囊前120分钟服用安慰剂片（P方案）。主要观察指标为胃排空时间（GTT）和小肠排空时间（SBTT）。次要观察指标为小肠清洁度和小肠内液体评分。小肠胶囊内镜图像质量和小肠内液体情况按5分制进行评估。
所有病例中胶囊均进入小肠。P方案的中位GTT为57.3（3 - 221）分钟，L方案为61.3（10 - 218）分钟（P = 0.836）。P方案的中位SBTT为245.0（164 - 353）分钟，L方案为228.05（116 - 502）分钟（P = 0.501）。P方案小肠图像质量评分为3.05±1.08，L方案为3.80±0.49（P < 0.001）。P方案小肠内液体评分为2.04±1.58，L方案为2.72±1.43（P < 0.001）。两种方案在图像质量方面存在显著差异。L方案的液体评分比P方案更高。本研究中无胶囊滞留或严重不良事件发生。
我们的研究表明，在CE前使用鲁比前列酮可通过促使小肠分泌液体，显著改善CE期间小肠的可视性。
