Effects of Acotiamide on the Esophageal Motility Function in Patients with Esophageal Motility Disorders: A Pilot Study
Effects of Acotiamide on the Esophageal Motility Function in Patients with Esophageal Motility Disorders: A Pilot Study
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DOI：
10.1159/000447010
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发表时间：
2016-01-01
期刊：
影响因子：
3.2
通讯作者：
Nakamura, Kazuhiko
中科院分区：
文献类型：
--
作者：
Muta, Kazumasa;Ihara, Eikichi;Nakamura, Kazuhiko
背景与目的：阿考替胺是一种新型的促动力药，临床上用于治疗功能性消化不良（FD）。本研究的目的是评估阿考替胺在食管动力障碍（EMD）患者中的治疗效果。方法：29例同时有FD症状和可疑EMD症状的患者入选。在阿考硫胺（100 mg）每日3次给药2周前后，通过高分辨率测压法评价食管运动功能。结果如下：29例患者被诊断为贲门失弛缓症（n = 4），食管胃连接部流出道梗阻（EGJOO）（n = 6），缺如（n = 2），远端食管痉挛（n = 4），频繁失败的食管痉挛（n = 7），弱食管痉挛（n = 2），其中4例被发现是正常的。对所有29例患者的分析显示，阿考替胺对基于远端收缩积分（DCI）、基础下食管括约肌（LES）压力或积分舒张压（IRP）的结果无影响。然而，亚组分析显示，在6例EGJOO患者中，阿考替胺显著降低了IRP，从19.5（15.1-30.8）降至12.1（5.6-16.4）mmHg，降低了DCI，从2，517.9（1，451.0 - 8，385.0）降至1，872.5（812.3- 5，225.3）mmHg.cm.s。结论：乙酰替胺可能使EGJOO患者的LES松弛受损正常化，而对正常食管动力模式无影响。Acotiamide可能是一种有前途的治疗EGJOO。(C)2016 S. Karger AG，巴塞尔
Background and Aim: Acotiamide is a'newly developed pro kinetic drug that is clinically used to treat functional dyspepsia (FD). The objective of this study was to assess the therapeutic effects of acotiamide in patients with esophageal motility disorders (EMDs). Methods: Twenty-nine patients with both symptoms of FD and symptoms suspicious of EMDs were enrolled. Esophageal motility function was evaluated by high-resolution manometry before and after 2 weeks administration of acotiamide (100 mg) 3 times per day. Results: Twenty-nine patients were diagnosed with achalasia (n = 4), esophagogastric junction outflow obstruction (EGJOO) (n = 6), absent peristalsis (n = 2), distal esophageal spasm (n = 4), frequently failed peristalsis (n = 7), weak peristalsis (n = 2) and 4 of them were found to be normal. An analysis in all 29 patients showed that acotiamide had no effects on based on distal contractile integral (DCI), basal lower esophageal sphincter (LES) pressure, or integrated relaxation pressure (IRP). Subgroup analysis, however, showed that acotiamide dramatically reduced IRP, from 19.5 (15.1-30.8) to 12.1 (5.6-16.4) mm Hg, and DCI, from 2,517.9 (1,451.0-8,385.0) to 1,872.5 (812.3-5,225.3) mm Hg.cm.s, in the 6 patients with EGJOO. Conclusions: Acotiamide potentially normalized impaired LES relaxation in patients with EGJOO, while having no effects on normal esophageal motility patterns. Acotiamide may be a promising treatment for EGJOO. (C) 2016 S. Karger AG, Basel