Tsiaoussis I, Xynos E, Tzovaras G, Chrysos E, Glynos M, Vassilakis J S
Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Greece.
Dig Dis Sci. 1998 Jan;43(1):178-82. doi: 10.1023/a:1018804927516.
It has been recently shown that erythromycin, a macrolide antibiotic, exhibits prokinetic properties, by enhancing gastric emptying in health and disease and by inducing gallbladder contraction. The aim of the study was to further investigate the effect of intravenous erythromycin on gallbladder motility during fasting and postprandial states. In 10 healthy male subjects gallbladder emptying was assessed by ultrasonography on three different occasions, each in a random sequence, as follows: (1) after giving 300 ml of fresh milk and infusing normal saline as placebo (postprandial emptying), (2) after infusing 200 mg of erythromycin during the fasting state, and (3) after infusing 200 mg of erythromycin along with ingestion of 300 ml of fresh milk. Infusion of erythromycin and placebo lasted 10 min. From the emptying curves, the duration of the lag phase of emptying, the ejection fraction of emptying, and the time by which maximal emptying was achieved were calculated. Infusion of erythromycin induced an immediate contraction [lag phase (+/-SD): 1.3+/-2.6 SD min] of the gallbladder by 42.1+/-22% of its initial volume. Infusion of erythromycin during the postprandial state significantly decreased the duration of the lag phase (1.3+/-3.5 min after erythromycin plus test meal versus 3.6+/-4.2 min after test meal only, P < 0.04) and significantly increased the ejection fraction (78+/-8.5% after erythromycin plus test meal versus 60.6+/-8.5% after test meal only, P < 0.0008). It is concluded that intravenously given erythromycin induces contraction of the gallbladder during the fasting state and enhances postprandial gallbladder emptying by accelerating the initiation and increasing the extent of emptying.
最近研究表明，大环内酯类抗生素红霉素具有促动力特性，可增强健康人和患病者的胃排空，并引起胆囊收缩。本研究的目的是进一步探讨静脉注射红霉素在禁食和餐后状态下对胆囊运动的影响。对10名健康男性受试者在三种不同情况下通过超声检查评估胆囊排空情况，每种情况按随机顺序进行，具体如下：(1)在给予300 ml新鲜牛奶并输注生理盐水作为安慰剂后（餐后排空），(2)在禁食状态下输注200 mg红霉素后，(3)在输注200 mg红霉素并同时摄入300 ml新鲜牛奶后。红霉素和安慰剂的输注持续10分钟。根据排空曲线，计算排空延迟期的持续时间、排空射血分数以及达到最大排空的时间。输注红霉素可使胆囊立即收缩[延迟期(±标准差)：1.3±2.6标准差分钟]，收缩幅度为初始体积的42.1±22%。餐后状态下输注红霉素可显著缩短延迟期的持续时间（红霉素加试验餐后为1.3±3.5分钟，仅试验餐后为3.6±4.2分钟，P<0.04），并显著增加射血分数（红霉素加试验餐后为78±8.5%，仅试验餐后为60.6±8.5%，P<0.0008）。结论是，静脉注射红霉素在禁食状态下可引起胆囊收缩，并通过加速排空起始和增加排空程度来增强餐后胆囊排空。
