Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study.
Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study.
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DOI：
10.1007/s12664-009-0048-6
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发表时间：
2009-07
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影响因子：
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通讯作者：
Summers R
中科院分区：
文献类型：
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作者：
Nasr I;Rao SS;Attaluri A;Hashmi SM;Summers R
替加色罗增强健康受试者的上消化道转运。然而，其对胃窦/小肠运动的促动力作用以及与红霉素的比较尚不清楚。我们前瞻性地评估和比较了替加色罗和红霉素对上消化道运动的影响。22例上肠动力障碍患者（男/女= 4/18;平均年龄= 37）使用6探头固态探头进行了24小时动态胃窦十二指肠空肠测压。通过量化压力波活动和评估运动模式，比较了12 mg口服替加色罗与125 mg静脉注射红霉素的效果。与基线期相比，两种药物均使胃窦、十二指肠和空肠的运动活动增加（p<0.05）。替加色罗组空肠的运动反应更高（p<0.05），发生在第2/3小时，而红霉素组胃窦的运动反应更高（p<0.05），发生在30分钟内。替加色罗后，观察到“进食反应”样模式，而红霉素后，观察到3个周期/分钟的大幅度（> 100 mmHg）胃窦收缩。替加色罗组和红霉素组分别有12例（55%）和8例（36%）患者出现III期MMC（p > 0.05）。这两种药物都能增加上消化道蠕动并诱导MMC，但产生不同的反应。替加色罗在十二指肠/空肠中产生更持续的促动力作用，而红霉素主要增加胃窦运动活动。
Tegaserod enhances upper gut transit in healthy subjects. However, its prokinetic effects on antral/small bowel motility and how this compares with erythromycin is unknown. We prospectively assessed and compared the effects of tegaserod and erythromycin on upper gut motility. 22 patients (M/F = 4/18; mean age = 37) with upper gut dysmotility underwent 24 hour ambulatory antroduodenojejunal manometry with a 6 sensor solid state probe. The effects of 12 mg oral tegaserod were compared with 125 mg intravenous erythromycin by quantifying pressure wave activity and assessing motor patterns. Motor activity increased (p<0.05) in antrum, duodenum and jejunum with both drugs when compared to baseline period. The motor response with tegaserod was higher (p<0.05) in jejunum and occurred during the 2nd/3rd hours, whereas with erythromycin, it was higher (p<0.05) in antrum and occurred within 30 min. After tegaserod, a ‘fed-response’ like pattern was seen whereas after erythromycin, large amplitude (> 100 mmHg) antral contractions at 3 cycles/min were seen. Following tegaserod and erythromycin, phase III MMCs occurred in 12 (55%) and 8 (36%) patients respectively (p > 0.05). Both drugs increase upper gut motility and induce MMC’s, but exert a differential response. Tegaserod produces a more sustained prokinetic effect in the duodenum/jejunum, whereas erythromycin predominantly increases antral motor activity.