Marraccini P, Braccini G, Marrucci A, Boraschi P, Bertellotti L, Testa R
CNR Institute of Clinical Physiology, via Savi, 8, I-56100 Pisa, Italy.
Abdom Imaging. 1996 Jul-Aug;21(4):304-8. doi: 10.1007/s002619900069.
To evaluate the usefulness of pirenzepine for diagnostic double-contrast barium enema study of the large bowel, pirenzepine and scopolamine methyl bromide (SMB) were compared in a single, blind, randomized trial. Sixty consecutive patients were enrolled in the study. Quantitative analysis of bowel distention was done by measuring the maximum diameter of the transverse colon before and after drug administration. Four independent observers blindly evaluated distention and mucosal coating of the large bowel and global quality of the images. No differences were found in the diagnostic performance between the two drugs. However, pirenzepine induced a slight but significantly larger distention of the large bowel (68 +/- 12 vs. 65 +/- 8 mm, p = 0.02). Heart rate and rhythm during the study were recorded by ECG. SMB induced tachycardia in all patients (from 72 +/- 15 to 98 +/- 24 beats/min, p < 0.01), whereas pirenzepine did not (from 76 +/- 13 to 78 +/- 20, p = NS). After SMB, one-patient exhibited faintness, and some patients complained of visual accommodation defects, dryness of the mouth, and dizziness. Pirenzepine had a diagnostic performance similar to SMB in avoiding adverse effects elicited by SMB.
为评估哌仑西平在大肠诊断性双对比钡灌肠研究中的效用，在一项单盲随机试验中对哌仑西平和甲溴东莨菪碱（SMB）进行了比较。连续60例患者纳入该研究。通过测量给药前后横结肠的最大直径对肠扩张进行定量分析。四名独立观察者对大肠的扩张、黏膜涂布及图像整体质量进行盲法评估。两种药物的诊断性能未发现差异。然而，哌仑西平使大肠出现轻微但显著更大的扩张（68±12 vs. 65±8 mm，p = 0.02）。研究期间通过心电图记录心率和心律。SMB使所有患者出现心动过速（从72±15次/分钟增至98±24次/分钟，p < 0.01），而哌仑西平未导致心动过速（从76±13次/分钟增至78±20次/分钟，p = 无显著性差异）。使用SMB后，1例患者出现头晕，部分患者主诉有视觉调节障碍、口干和头晕。哌仑西平在避免SMB引发的不良反应方面具有与SMB相似的诊断性能。
