Domperidone is more effective than cisapride in children with diabetic gastroparesis
Domperidone is more effective than cisapride in children with diabetic gastroparesis
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DOI：
10.1046/j.1365-2036.2002.01240.x
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发表时间：
2002-05-01
影响因子：
7.6
通讯作者：
Cucchiara, S
中科院分区：
文献类型：
--
作者：
Franzese, A;Borrelli, O;Cucchiara, S
背景：胃肠动力障碍常见于胰岛素依赖型糖尿病患者，并且与显着的发病率相关。它们会导致糖尿病的代谢控制不佳。目的：评估多潘立酮或西沙比利 8 周疗程对胰岛素依赖型糖尿病和胃轻瘫儿童胃电活动、胃排空时间和消化不良症状的影响。方法：通过评分系统评估消化不良症状，通过超声检查测量胃排空时间，通过胃电图获得胃电活动。 14 名儿童接受多潘立酮治疗，14 名儿童接受西沙必利治疗。中位年龄（范围）分别为 11.6 岁（5-15 岁）和 12 岁（6-16.9 岁）。试验结束时重复进行症状评估、超声检查和胃电图检查。还测量了空腹和进食（进食后 180 分钟）血糖和血红蛋白 A、C (HbA(1c)) 水平。 结果：试验结束时，两组症状评分均显着下降；但多潘立酮组评分明显低于西沙必利组（P < 0.01）。多潘立酮在缩短胃排空时间（P < 0.05）、使胃电活动正常化（P < 0.05）和降低胃心律失常发作率（P < 0.01）方面显着优于西沙必利。多潘立酮在改善糖尿病代谢控制方面也比西沙必利更有效。未发生潜在的药物相关不良反应。 结论：对于胰岛素依赖型糖尿病并发消化不良症状和胃轻瘫的儿童，多潘立酮在逆转胃排空延迟和胃电异常、改善消化不良症状和糖尿病代谢控制方面优于西沙必利。
Background: Disorders of gastrointestinal motility are commonly detected in patients with insulin-dependent diabetes mellitus and are associated with significant morbidity. They contribute to poor metabolic control of diabetes.Aim: To assess the effect of an 8-week course of domperidone or cisapride on gastric electrical activity, gastric emptying time and dyspeptic symptoms in children with insulin-dependent diabetes mellitus and gastroparesis.Methods: Dyspeptic symptoms were assessed by a score system, gastric emptying time was measured by ultrasonography and gastric electrical activity was obtained by electrogastrography. Fourteen children received domperidone and 14 received cisapride. The median (range) ages were 11.6 years (5-15 years) and 12 years (6-16.9 years), respectively. Symptom assessment, ultrasonography and electrogastrography were repeated at the end of the trial. Fasting and fed (180 min after feeding) glycaemia and haemoglobin A, C (HbA(1c)) levels were also measured.Results: At the end of the trial both groups showed a significant decrease in symptomatic score; however, the score was markedly lower in the domperidone group than in the cisapride group (P < 0.01). Domperidone was significantly more effective than cisapride in reducing the gastric emptying time (P < 0.05), normalizing gastric electrical activity (P < 0.05) and decreasing the prevalence of episodes of gastric dysrhythmia (P < 0.01). Domperidone was also more effective than cisapride in improving diabetic metabolic control. No potentially drug-related adverse effects occurred.Conclusions: In children with insulin-dependent diabetes mellitus complicated by dyspeptic symptoms and gastroparesis, domperidone is superior to cisapride in reversing gastric emptying delay and gastric electrical abnormalities, as well as in improving dyspeptic symptoms and diabetic metabolic control.