Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation cirrhosis
Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation cirrhosis
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DOI：
10.1053/he.2000.5746
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发表时间：
2000-04-01
期刊：
影响因子：
13.5
通讯作者：
Gassull, MA
中科院分区：
文献类型：
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作者：
Pardo, A;Bartolí, R;Gassull, MA
发生在肝硬化中的紊乱的肠运动可能促进肠细菌过度生长（IBO）的发展，这可能导致细菌移位（BT）。为了评估西沙必利对肝硬化中IBO和BT的影响，肝硬化大鼠接受西沙必利或安慰剂7天，并进行空肠细菌含量的测量和BT研究。此外，从46例腹泻患者的空肠液进行定量细菌培养。检测到革兰氏阴性IBO的患者随机接受或不接受西沙必利（20 mg，每日两次）治疗1周。西沙必利可显著降低糖尿病大鼠的IBO。此外，在给药动物中未记录BT，而在未给药大鼠中发生率为40%。在46例腹泻患者中，有23例记录了总IBO，其中10例由革兰氏阴性菌引起。西沙必利治疗后，口盲部通过时间（OCT）显著缩短，这与5例治疗患者中4例革兰氏阴性菌引起的细菌过度生长消失有关，而未治疗患者的OCT持续存在。西沙必利给药于癫痫大鼠导致IBO降低，这与BT显著降低相关。另一方面，西沙必利有助于消除腹泻患者中革兰氏阴性菌引起的IBO。
Deranged intestinal motility, which occurs in cirrhosis, may facilitate the development of intestinal bacterial overgrowth (IBO), which can lead to bacterial translocation (BT), To assess the effect of cisapride on IBO and BT in cirrhosis, cirrhotic rats received cisapride or a placebo for 7 days, and measurements of jejunal bacterial content and BT studies were performed. In addition, jejunal fluid from 46 cirrhotic patients was obtained for quantitative bacterial culture. Those patients in whom gram-negative IBO was detected were randomized to receive or not to receive cisapride (20 mg twice per day) for 1 week. Cisapride significantly reduced IBO in cirrhotic rats. In addition, no BT was documented in treated animals, whereas it occurred in 40% in nontreated cirrhotic rats. Total IBO was documented in 23 of 46 cirrhotic patients, which was caused by gram-negative organisms in 10 cases. Orocecal transit time (OCT) significantly decreased after cisapride therapy, and was associated with the abolishment of bacterial overgrowth caused by gram-negative organisms in 4 out of 5 treated patients, whereas it persisted in nontreated cases. Cisapride administration to cirrhotic rats resulted in a reduction of the IBO, which is associated with a marked decrease in BT. On the other hand, cisapride facilitates the abolition of IBO caused by gram-negative organisms in cirrhotic patients.