5-羟色胺3拮抗剂可纠正类癌性腹泻患者的餐后结肠高渗反应。

A 5HT3 antagonist corrects the postprandial colonic hypertonic response in carcinoid diarrhea.

作者信息

von der Ohe M R, Camilleri M, Kvols L K

机构信息

Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota.

出版信息

Gastroenterology. 1994 May;106(5):1184-9. doi: 10.1016/0016-5085(94)90008-6.

DOI:10.1016/0016-5085(94)90008-6

PMID:8174881

Abstract

BACKGROUND/AIMS: Carcinoid patients show a hypertonic colonic motor response postprandially. Ondansetron reduces postprandial colonic tone in health. It was hypothesized that ondansetron, a selective 5HT3 antagonist, corrects the colonic motor response to eating in carcinoid diarrhea.

METHODS

The effects of ondansetron and placebo on fasting and postprandial colonic tone and motility in 10 patients with carcinoid diarrhea were compared using a manometry-barostat assembly positioned in the upper descending colon.

RESULTS

Fasting colonic tone and motility indices were similar in the placebo and ondansetron groups; ondansetron did not affect fasting motility. The placebo group showed a significant reduction in barostat balloon volume (signifying increased tone) from 207 +/- 29 mL (mean +/- SEM) during fasting to 106 +/- 14 mL postprandially (P = 0.01). With ondansetron, a tonic colonic response was induced postprandially (198 +/- 37 mL to 151 +/- 30 mL; P = 0.053). However, the increment in tone in the ondansetron group (23% +/- 7%) was significantly lower than in the placebo group (48% +/- 5%; P = 0.02) and was similar to that observed in untreated healthy subjects (24% +/- 3%). Postprandial manometric pressure activity increased significantly in the placebo group (P = 0.01); in the ondansetron group there was a trend (P = 0.09) to increased phasic activity.

CONCLUSIONS

Ondastetron reduces the postprandial colonic hypertonic response in carcinoid diarrhea to levels previously reported in health; further clinical studies of this class of antagonists in carcinoid diarrhea appear warranted.

摘要

背景/目的：类癌患者餐后呈现高张性结肠运动反应。昂丹司琼可降低健康人餐后的结肠张力。据推测，作为一种选择性5-羟色胺3（5HT3）拮抗剂，昂丹司琼可纠正类癌性腹泻患者进食后的结肠运动反应。

方法

使用置于降结肠上段的测压-恒压器组件，比较了昂丹司琼和安慰剂对10例类癌性腹泻患者空腹及餐后结肠张力和运动性的影响。

结果

安慰剂组和昂丹司琼组的空腹结肠张力和运动指数相似；昂丹司琼不影响空腹运动性。安慰剂组恒压器气囊容积从空腹时的207±29 ml（均值±标准误）显著降至餐后的106±14 ml（P = 0.01），提示张力增加。使用昂丹司琼时，餐后诱导出了结肠强直性反应（从198±37 ml至151±30 ml；P = 0.053）。然而，昂丹司琼组的张力增加幅度（23%±7%）显著低于安慰剂组（48%±5%；P = 0.02），且与未治疗的健康受试者观察到的增加幅度（24%±3%）相似。安慰剂组餐后测压压力活动显著增加（P = 0.01）；昂丹司琼组有相位活动增加的趋势（P = 0.09）。