Lee Jin, Jeong Su Jin, Kim Tae Hyung, Park Yong Eun, Choi Joon Hyuk, Heo Nae-Yun, Park Jongha, Park Seung Ha, Moon Young Soo, Kim Tae Oh
Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.
Medicine (Baltimore). 2020 Jan;99(2):e18702. doi: 10.1097/MD.0000000000018702.
BACKGROUND/AIMS: Old age is a risk factor of suboptimal bowel preparation. This study aimed to evaluate the efficacy of mosapride citrate with a split dose of polyethylene glycol (PEG) plus ascorbic acid for bowel preparation in elderly patients (aged ≥65 years) before they underwent a colonoscopy.
This prospective investigator-blinded randomized study was conducted from November 2017 to October 2018. The patients were randomly divided into 2 groups, a mosapride group (mosapride citrate with a split-dose of PEG plus ascorbic acid) or a non-mosapride group (a split-dose of PEG plus ascorbic acid alone). Mosapride citrate 15 mg (Gastin CR) was administered once with each split-dose of the bowel preparation. The bowel preparation quality was assessed using the Boston Bowel Preparation Scale (BBPS).
A total of 257 patients were finally included and analyzed in our study. The total BBPS score was significantly higher in the mosapride group than in the non-mosapride group (8.53 vs 8.24, P = .033). The BBPS scores of the right colon and mid-colon were 2.75 vs 2.61 (P = .044) and 2.89 vs 2.79 (P = .030), respectively. The rate of adequate bowel preparation (BBPS ≥ 6) was similar in both groups (98.4% vs 98.5%, P = .968), while the rate of excellent bowel preparation (BBPS = 9) was higher in the mosapride group than in the non-mosapride group (73.8% vs 61.1%, P = .029). The total incidence of adverse events during the administration of the bowel cleansing agent, particularly abdominal fullness, was lower in the mosapride group (11.9% vs 30.5%, P < .001).
The administration of mosapride citrate with a split-dose of PEG plus ascorbic acid in elderly patients showed an increase in bowel preparation efficacy and reduced adverse events, particularly abdominal fullness, during the administration of a bowel cleansing agent.
背景/目的:高龄是肠道准备不佳的一个风险因素。本研究旨在评估枸橼酸莫沙必利联合分剂量聚乙二醇(PEG)加抗坏血酸用于老年患者(年龄≥65岁)结肠镜检查前肠道准备的效果。
本前瞻性研究者设盲随机研究于2017年11月至2018年10月进行。患者被随机分为两组,莫沙必利组(枸橼酸莫沙必利联合分剂量PEG加抗坏血酸)和非莫沙必利组(仅分剂量PEG加抗坏血酸)。每次肠道准备分剂量给药时均给予15毫克枸橼酸莫沙必利(加斯清控释片)。使用波士顿肠道准备量表(BBPS)评估肠道准备质量。
本研究最终纳入并分析了257例患者。莫沙必利组的总BBPS评分显著高于非莫沙必利组(8.53对8.24,P = 0.033)。右半结肠和结肠中部的BBPS评分分别为2.75对2.61(P = 0.044)和2.89对2.79(P = 0.030)。两组的充分肠道准备率(BBPS≥6)相似(98.4%对98.5%,P = 0.968),而莫沙必利组的优质肠道准备率(BBPS = 9)高于非莫沙必利组(73.8%对61.1%,P = 0.029)。肠道清洁剂给药期间不良事件的总发生率,尤其是腹部饱胀感,莫沙必利组较低(11.9%对30.5%,P < 0.001)。
老年患者使用枸橼酸莫沙必利联合分剂量PEG加抗坏血酸进行肠道准备,可提高肠道准备效果,并减少肠道清洁剂给药期间的不良事件,尤其是腹部饱胀感。