Eberl T, Barnert J, Dumitrascu D L, Fischer J, Wienbeck M
Third Department of Internal Medicine, Zentralklinikum Augsburg, Germany.
Eur J Gastroenterol Hepatol. 1998 Dec;10(12):991-5. doi: 10.1097/00042737-199812000-00002.
To test the effect of cisapride on symptom score and on fasting and postprandial antral area in patients with dysmotility-like functional dyspepsia compared with controls.
Nineteen consecutive patients with dysmotility-like functional dyspepsia (13 females, six males, aged 18-79 y) and 12 control subjects (six females, six males, aged 19-68 y) were investigated. A symptom score including six upper digestive symptoms rated from 0 to 3 was applied. The patients received in a randomized order cisapride 10 mg t.i.d. (n = 10), or placebo (n = 9) for 3 days. The controls also received cisapride (n = 6) or placebo (n = 6) in the same way. The antral area in fasting condition and immediately after a semiliquid test meal (250 ml, 342 kcal) was assessed by real-time ultrasonography in front of the aorta and mesenteric vein. The measurements were carried out before starting and after finishing the trials with cisapride and placebo.
The symptom score (mean +/- SD) was 7.1 +/- 2.4 in dysmotility-like functional dyspepsia vs 0.5 +/- 0.2 in controls (P < 0.0001). The fasting antral area was 4.5 +/- 0.9 cm2 in dysmotility-like functional dyspepsia vs 2.2 +/- 0.2 cm2 in controls (P < 0.0001). Postprandial antral area was also larger in dysmotility-like dyspepsia than in controls (6.2 +/- 1.0 vs 3.0 +/- 0.3 cm2, Pb= 0.0001). Symptom score correlated with fasting antral area in dysmotility-like functional dyspepsia (rb= 0.38, Pb= 0.05). Cisapride decreased the symptom score to 4.5 +/- 2.5 (P = 0.0009) and placebo to 5.3 +/- 2.4 (P = 0.02). Cisapride significantly reduced the fasting antral area and the postprandial antral area in the dyspeptic group, but not in the control group. Postprandial antral expansion was not influenced by cisapride. Placebo did not change the sonographic parameters in both groups.
In dysmotility-like functional dyspepsia, fasting and postprandial antral areas are wider than in controls. Despite a good placebo response, cisapride is effective in improving the symptoms in dysmotility-like functional dyspepsia, associated with the reduction of fasting and postprandial antral areas.
与对照组相比，检测西沙必利对运动障碍样功能性消化不良患者症状评分以及空腹和餐后胃窦面积的影响。
对19例连续的运动障碍样功能性消化不良患者（13例女性，6例男性，年龄18 - 79岁）和12例对照者（6例女性，6例男性，年龄19 - 68岁）进行研究。应用包括6种上消化道症状、评分从0至3的症状评分。患者随机接受西沙必利10毫克每日3次（n = 10），或安慰剂（n = 9），疗程3天。对照组也以同样方式接受西沙必利（n = 6）或安慰剂（n = 6）。通过在腹主动脉和肠系膜静脉前方进行实时超声检查评估空腹状态下以及半流质试验餐（250毫升，342千卡）后即刻的胃窦面积。在开始和结束西沙必利及安慰剂试验前和后进行测量。
运动障碍样功能性消化不良患者的症状评分（均值±标准差）为7.1±2.4，而对照组为0.5±0.2（P < 0.0001）。运动障碍样功能性消化不良患者的空腹胃窦面积为4.5±0.9平方厘米，对照组为2.2±0.2平方厘米（P < 0.0001）。运动障碍样消化不良患者的餐后胃窦面积也大于对照组（6.2±1.0对3.0±0.3平方厘米，Pb = 0.0001）。运动障碍样功能性消化不良患者的症状评分与空腹胃窦面积相关（rb = 0.38，Pb = 0.05）。西沙必利使症状评分降至4.5±2.5（P = 0.0009），安慰剂使其降至5.3±- 2.4（P = 0.02）。西沙必利显著降低了消化不良组的空腹胃窦面积和餐后胃窦面积，但对照组未降低。西沙必利未影响餐后胃窦扩张。安慰剂在两组中均未改变超声参数。
在运动障碍样功能性消化不良中，空腹和餐后胃窦面积比对照组更宽。尽管安慰剂反应良好，但西沙必利在改善运动障碍样功能性消化不良症状方面有效，且与空腹和餐后胃窦面积减小相关。
