奥美拉唑对人胃胆囊排空的影响及其相关机制研究  

Effects of omeprazole on the gastric and gallbladder emptying in man and its possible mechanisms.

作　　者：邢进宏[1] 柯美云[1] 陈元方[1] 王智凤[1] 孙纲 张淑琴[1] 徐竞英[1] 

机构地区：[1]中国医学科学院,中国协和医科大学,北京协和医院

出　　处：《中华消化杂志》1997年第4期207-210,共4页Chinese Journal of Digestion

摘　　要：目的：为了探讨强力抑酸剂奥美拉唑对反流性食管炎患者胃排空和胆囊排空的影响及可能的机制。方法：采用核素胃排空法及胆囊超声法观察了服用奥美拉唑（２０ｍｇ／日，７天）对８例正常人与９例反流性食管炎患者胃、胆囊排空的影响，进而用放免法测定７例正常人用奥美拉唑后血清生长抑素（ＳＳＴ）、血管活性肠肽（ＶＩＰ）和胰多肽（ＰＰ）以及生物法测定血清胆囊收缩素（ＣＣＫ）的变化。结果：用药后正常组与反流组餐后２小时胃排空率分别从６４．１％±７．６％和６８．０％±４．５％降至２８．９的±６．４％和２９．８％±５．５％（Ｐ值均＜０．００１）；胆囊最大排空率也分别从８９．４％±１．７的和７４．７％±１．９％降至６５．６的±４．７％和５０．５％±５．０％（Ｐ值均（０．００１），胆囊持续收缩排空的时间明显缩短，用药后基础与餐后ＳＳＴ．ＶＩＰ．ＣＣＫ水平无明显改变；但餐后ＰＰ释放显著减少（Ｐ＜０．０５）。结论：抑酸后血浆ＰＰ释放显著减少，与迷走胆碱能神经张力下降有关，可能是胃、胆囊动力改变的重要原因之一，我们认为强力抑酸不宜长期单独用于反流性食管炎治疗。与促动力药物合用比较合理。Objective: Omeprazole(Ome) has been extensively used in the treatment of reflux esophagitis(RE), The aims of this study were to verify the effects of potent acid inhibition on gastric and gallbladder motility and its possible mechanism. Subjects and methods: 8 healthy and 9 patients with reflux esophagitis received the scintigraphic gastric emptying and ultrasonographic gallbladder emptying before and after 6-7 days of administration of omeprazole (20 mg daily ) (one RE did not receive gallbladder study), to observe the effects of Ome on serum level of SST, VIP, CCK and PP in 6 HS. Results: The gastric emptying rate was reduced from 64.1 %±7.6% to 28.9%±6.4. in HS (P<0.001) and 68.0% ±4.5 to 29.8%±5.5% in RE patients (P<0.001), the maximal gallbladder emptying rate was reduced from 89.4%± 1 .7 % to 66.6 %±4.7 % in HS (P< 0.001) and 74.7%±1.9% to 50.5%±5.0%in RE patients (P<0.001). Ome had not caused obvious alteration of the serum concentration of SST. VIP and CCK, except postprandial PP release which was reduced greatly (P.0.05). Conclusion: The reduced vagal tone may be responsible for the delayed gastric and gallbladder emptying. Long-term potent acid inhibition should not be used singly in RE patients , combined therapy with prokinetic drugs may be a reasonable choice.

关 键 词：返流性食管炎 胃排空 胆囊排空 奥美拉唑 

分 类 号：R571.05[医药卫生—消化系统]