Parkman H P, Urbain J L, Knight L C, Brown K L, Trate D M, Miller M A, Maurer A H, Fisher R S
Department of Medicine and Nuclear Medicine Section, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Gut. 1998 Feb;42(2):243-50. doi: 10.1136/gut.42.2.243.
The effect of histamine H2 receptor antagonists on gastric emptying is controversial.
To determine the effects of ranitidine, famotidine, and omeprazole on gastric motility and emptying.
Fifteen normal subjects underwent simultaneous antroduodenal manometry, electrogastrography (EGG), and gastric emptying with dynamic antral scintigraphy (DAS). After 30 minutes of fasting manometry and EGG recording, subjects received either intravenous saline, ranitidine, or famotidine, followed by another 30 minutes recording and then three hours of postprandial recording after ingestion of a radiolabelled meal. Images were obtained every 10-15 minutes for three hours to measure gastric emptying and assess antral contractility. Similar testing was performed after omeprazole 20 mg daily for one week.
Fasting antral phase III migrating motor complexes (MMCs) were more common after ranitidine (9/15 subjects, 60%), famotidine (12/15, 80%), and omeprazole (8/12, 67%) compared with placebo (4/14, 29%; p < 0.05). Postprandially, ranitidine, famotidine, and omeprazole slowed gastric emptying, increased the amplitude of DAS contractions, increased the EGG power, and increased the antral manometric motility index.
Suppression of gastric acid secretion with therapeutic doses of gastric acid suppressants is associated with delayed gastric emptying but increased antral motility.
组胺H2受体拮抗剂对胃排空的影响存在争议。
确定雷尼替丁、法莫替丁和奥美拉唑对胃动力和排空的影响。
15名正常受试者同时进行十二指肠测压、胃电图（EGG）检查以及使用动态胃窦闪烁扫描（DAS）测定胃排空。在禁食状态下进行30分钟的测压和EGG记录后，受试者接受静脉注射生理盐水、雷尼替丁或法莫替丁，随后再进行30分钟记录，接着在摄入放射性标记餐食后进行3小时的餐后记录。每10 - 15分钟获取一次图像，持续3小时，以测量胃排空并评估胃窦收缩性。在每日服用20毫克奥美拉唑一周后进行类似测试。
与安慰剂组（4/14，29%；p < 0.05）相比，雷尼替丁组（9/15名受试者，60%）、法莫替丁组（12/15，80%）和奥美拉唑组（8/12，67%）在禁食状态下胃窦Ⅲ期移行性运动复合波（MMCs）更为常见。餐后，雷尼替丁、法莫替丁和奥美拉唑均减缓了胃排空，增加了DAS收缩幅度，提高了EGG功率，并增加了胃窦测压运动指数。
治疗剂量的胃酸抑制剂抑制胃酸分泌与胃排空延迟但胃窦动力增加有关。
