Bottaro G, Rotolo N, Spina M, Azzaro F, Galletta C, Romano D, Castiglione N, Patanè R
1 Clinica Pediatrica, Policlinico di Catania, Università di Catania, Italia.
Pediatr Med Chir. 1993 Mar-Apr;15(2):141-4.
In the last years gastroesophageal reflux disease received more attentions, due to an improving in diagnostic techniques. Motility disorders, such as reduced competence of lower esophageal sphincter, motor esophageal disorders, delayed gastric emptying are important factors in the pathogenesis of the disease. Therefore therapy using prokinetic agents has been considered useful. A variety of drugs such as bethanecol, metoclopramide and domperidone have been used. There are conflicting report on the effects of these drugs and it should also be emphasized that they are not devoid of side effects related to dopamine antagonism. Recently cisapride, prokinetic agent which acts through facilitation of acetylcholine release, has been considered effective and well tolerate drug for the treatment of gastroesophageal reflux disease. In this view we investigated the effects of oral administration of cisapride in 12 children (age range 3-40 months), 7 females and 5 males, suffering from gastroesophageal reflux disease diagnosed on the bases of: clinic criteria, barium swallow radiological examination, 24-hour intraesophageal pH monitoring. After diagnosis a treatment with cisapride (1 mg/kg/die) before feedings for 8 weeks was started in all children. At the end of the trial clinical assessment and 24-hour intraesophageal pH test were performed. Clinical assessment was determined through weight, length and a clinical score calculated using the following parameters: regurgitation, vomiting, irritability, nocturnal weeping, meteorism, respiratory complaints. The total score was evaluated at diagnosis and during the follow-up (1st, 2nd, 4th and 8th week).(ABSTRACT TRUNCATED AT 250 WORDS)
在过去几年中,由于诊断技术的进步,胃食管反流病受到了更多关注。动力障碍,如下食管括约肌功能不全、食管运动障碍、胃排空延迟,是该疾病发病机制中的重要因素。因此,使用促动力剂进行治疗被认为是有效的。已经使用了多种药物,如氨甲酰甲胆碱、甲氧氯普胺和多潘立酮。关于这些药物的疗效存在相互矛盾的报道,还应强调的是,它们并非没有与多巴胺拮抗相关的副作用。最近,西沙必利这种通过促进乙酰胆碱释放起作用的促动力剂,被认为是治疗胃食管反流病的有效且耐受性良好的药物。基于此观点,我们对12名(年龄范围3至40个月)患有胃食管反流病的儿童进行了研究,其中7名女性,5名男性,这些儿童的疾病诊断基于临床标准、钡餐放射学检查、24小时食管内pH监测。诊断后,所有儿童在喂食前开始服用西沙必利(1毫克/千克/日),持续8周。试验结束时进行了临床评估和24小时食管内pH测试。临床评估通过体重、身长以及使用以下参数计算的临床评分来确定:反流、呕吐、易怒、夜间啼哭、腹胀、呼吸问题。在诊断时以及随访期间(第1、2、4和8周)对总分进行评估。(摘要截断于250字)