Kendall B J, Chakravarti A, Kendall E, Soykan I, McCallum R W
Department of Medicine, University of Virginia, Charlottesville, USA.
Aliment Pharmacol Ther. 1997 Apr;11(2):381-5. doi: 10.1046/j.1365-2036.1997.148324000.x.
Chronic symptomatic gastroparesis occurs in 3-5% of patients following vagotomy and antrectomy. Erythromycin, a macrolide antibiotic, improves gastric emptying in patients with idiopathic and diabetic gastroparesis. Erythromycin's effect on gastric emptying in patients with post-vagotomy-antrectomy gastroparesis is unknown. The aim of this study was to determine if a single dose of intravenous erythromycin (1 mg/kg or 6 mg/kg) accelerates solid meal gastric emptying in patients with chronic symptomatic post-vagotomy-antrectomy gastroparesis.
Six patients were entered into the study, three males and three females, with a mean age of 50 years. Four patients were randomized to receive erythromycin 6 mg/kg and two patients 1 mg/kg. The mean time since initial surgery was 9.2 years (range 1-16 years) with five patients having undergone a Roux-en-Y revision.
Intravenous erythromycin significantly lowered percentage gastric retention at 120 min, from a baseline of 90.5 +/- 6% (S.E.M.) to 40.1 +/- 4.8% after erythromycin (P = 0.0002). Erythromycin improved gastric emptying in each patient by at least 40%. Intravenous erythromycin significantly accelerated the rate of gastric emptying in the first 30 min after meal ingestion from a baseline rate of 0.072 +/- 0.06%/min to 0.96 +/- 0.31%/min after erythromycin (P = 0.028). For each of the subsequent 30 minute time periods, erythromycin had no significant effect on the rate of gastric emptying.
Intravenous erythromycin significantly improves the initial phase of solid meal gastric emptying in patients with chronic symptomatic post-antrectomy-vagotomy gastroparesis.
慢性症状性胃轻瘫发生于3%至5%的迷走神经切断术和胃窦切除术后患者中。红霉素，一种大环内酯类抗生素，可改善特发性和糖尿病性胃轻瘫患者的胃排空。红霉素对迷走神经切断术-胃窦切除术后胃轻瘫患者胃排空的影响尚不清楚。本研究的目的是确定单剂量静脉注射红霉素（1毫克/千克或6毫克/千克）是否能加速慢性症状性迷走神经切断术-胃窦切除术后胃轻瘫患者固体餐的胃排空。
6名患者进入本研究，3名男性和3名女性，平均年龄50岁。4名患者随机接受6毫克/千克红霉素，2名患者接受1毫克/千克红霉素。自初次手术以来的平均时间为9.2年（范围1至16年），5名患者接受了Roux-en-Y改道术。
静脉注射红霉素显著降低了120分钟时胃潴留的百分比，从基线的90.5±6%（标准误）降至红霉素注射后的40.1±4.8%（P = 0.0002）。红霉素使每位患者的胃排空改善至少40%。静脉注射红霉素显著加速了餐后最初30分钟内的胃排空速度，从基线速度0.072±0.06%/分钟提高到红霉素注射后的0.96±0.31%/分钟（P = 0.028）。在随后的每个30分钟时间段内，红霉素对胃排空速度均无显著影响。
静脉注射红霉素显著改善了慢性症状性胃窦切除术后-迷走神经切断术胃轻瘫患者固体餐胃排空的初始阶段。
