Dworkin B M, Rosenthal W S, Casellas A R, Girolomo R, Lebovics E, Freeman S, Clark S B
Sarah C. Upham Division of Gastroenterology, New York Medical College, Valhalla 10595.
Dig Dis Sci. 1994 Jul;39(7):1395-8. doi: 10.1007/BF02088039.
Cisapride induces acetylcholine release in cells of the myenteric plexus, thus promoting gastrointestinal motility. We studied the effects of cisapride on 11 patients with idiopathic gastroparesis. All had negative gastrointestinal endoscopy, normal glucose, and took no drugs capable of influencing motility. Most (9/11) were prior metoclopramide treatment failures. Patients' symptoms were scored (0-60) for pain, satiety, bloating, nausea, vomiting, and heartburn. All underwent a solid gastric emptying study using a Technetium-99-labeled egg meal and received placebo prior to cisapride. There were 10 females and one male with a mean (+/- SE) age of 37.8 +/- 2.6 years. Disease duration was 7.9 +/- 2.8 years. The dose of cisapride was 30-60 mg/day and the duration of therapy was 12.6 +/- 2.6 months (range 2.5-25 months). The symptom score improved on cisapride from 30.9 +/- 3.6 to 14.4 +/- 2.7 (P < 0.002 signed rank test). Emptying half-time improved from 113 +/- 4 min to 94 +/- 6 min, and 46.9 +/- 2.4% food remaining at 120 min decreased to 35.5 +/- 3.6% (both P < 0.05). Emptying half-time in normals was 68 +/- 5 min with 16.9 +/- 2.9% remaining at 120 min. Nine of 11 patients gained weight, with a mean increase of 6.7 +/- 1.6 lb (range 2-12 lb). We conclude that cisapride significantly reduces gastrointestinal symptoms and promotes weight gain in patients with idiopathic gastroparesis and is associated with improvement in solid gastric emptying. The drug is useful in patients who previously failed metoclopramide.
西沙必利可诱导肌间神经丛细胞释放乙酰胆碱，从而促进胃肠蠕动。我们研究了西沙必利对11例特发性胃轻瘫患者的影响。所有患者的胃肠内镜检查均为阴性，血糖正常，且未服用能够影响胃肠动力的药物。大多数患者（9/11）之前使用甲氧氯普胺治疗失败。对患者的疼痛、饱腹感、腹胀、恶心、呕吐和烧心等症状进行评分（0 - 60分）。所有患者均使用99锝标记的鸡蛋餐进行固体胃排空研究，并在服用西沙必利之前接受安慰剂治疗。患者中有10名女性和1名男性，平均（±标准误）年龄为37.8±2.6岁。病程为7.9±2.8年。西沙必利的剂量为30 - 60毫克/天，治疗持续时间为12.6±2.6个月（范围为2.5 - 25个月）。服用西沙必利后，症状评分从30.9±3.6改善至14.4±2.7（符号秩检验，P < 0.002）。排空半衰期从113±4分钟改善至94±6分钟，120分钟时剩余食物从46.9±2.4%降至35.5±3.6%（两者P < 0.05）。正常人的排空半衰期为68±5分钟，120分钟时剩余16.9±2.9%。11例患者中有9例体重增加，平均增加6.7±1.6磅（范围为2 - 12磅）。我们得出结论，西沙必利可显著减轻特发性胃轻瘫患者的胃肠道症状并促进体重增加，且与固体胃排空改善有关。该药物对之前使用甲氧氯普胺治疗失败的患者有用。
