口服红霉素对糖尿病胃轻瘫患者的影响。

Effect of oral erythromycin on patients with diabetic gastroparesis.

作者信息

Pan D Y, Chen G H, Chang C S, Ho K S, Poon S K, Huang C K, Kao C H, Wang S J

机构信息

Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C.

出版信息

Zhonghua Yi Xue Za Zhi (Taipei). 1995 Jun;55(6):447-51.

PMID:7634182

Abstract

BACKGROUND

Abnormal gastrointestinal motility is a well recognized complication of diabetes mellitus, and disordered gastric emptying may hamper glycemic control. The objects of this study were to investigate the effect of oral erythromycin on gastric emptying and to evaluate the effect of corrected gastric emptying on glycemic control in patients with diabetic gastroparesis.

METHODS

Twenty patients of Type II (non-insulin-dependent) diabetes mellitus with typical symptoms of gastroparesis and delayed solid phase gastric emptying were studied. There were 18 males and 2 females, aged 49 to 72 years. Erythromycin (erythromycin estolate) was given orally at a dose of 250 mg, 3 times daily, 30 minutes before each meal. Radionuclide-labelled solid phase gastric emptying and fasting blood sugar (FBS) were studied after one day of erythromycin therapy, and again after 2 weeks of the therapy. The half time of gastric emptying (GETt1/2) represented the time needed for 50 percent of the initial radioactivity to leave the stomach, and was used to express the gastric emptying status.

RESULTS

The GETt1/2 decreased from 198.0 +/- 58.9 minutes at baseline to 139.1 +/- 67.6 minutes following one day of erythromycin therapy (p < 0.01), and to 137.1 +/- 71.2 minutes after two weeks of treatment (vs. baseline p < 0.01). The FBS decreased from 159.0 +/- 40.2 mg/dl at baseline to 149.0 +/- 38.5 mg/dl following one day of therapy (p = 0.12, NS), and to 139.2 +/- 39.8 mg/dl after two weeks of treatment (vs. baseline p < 0.02).

CONCLUSIONS

It was concluded that erythromycin is an effective prokinetic agent for diabetic gastroparesis, and that corrected gastric emptying may improve glycemic control.

摘要

背景

胃肠道动力异常是糖尿病公认的并发症，胃排空紊乱可能会妨碍血糖控制。本研究的目的是探讨口服红霉素对胃排空的影响，并评估纠正胃排空对糖尿病胃轻瘫患者血糖控制的效果。

方法

研究了20例患有胃轻瘫典型症状且固相胃排空延迟的II型（非胰岛素依赖型）糖尿病患者。其中男性18例，女性2例，年龄49至72岁。红霉素（依托红霉素）以250毫克的剂量口服，每日3次，在每餐饭前30分钟服用。在红霉素治疗1天后以及治疗2周后，分别研究放射性核素标记的固相胃排空和空腹血糖（FBS）。胃排空半衰期（GETt1/2）代表初始放射性的50%离开胃所需的时间，用于表示胃排空状态。

结果

胃排空半衰期（GETt1/2）从基线时的198.0±58.9分钟降至红霉素治疗1天后的139.1±67.6分钟（p<0.01），治疗2周后降至137.1±71.2分钟（与基线相比p<0.01）。空腹血糖（FBS）从基线时的159.0±40.2毫克/分升降至治疗1天后的149.0±38.5毫克/分升（p = 0.12，无统计学意义），治疗2周后降至139.2±39.8毫克/分升（与基线相比p<0.02）。