促胃肠动力药物对Oddi括约肌压力的影响  

Effects of gastrokinetic agents on human sphincter of Oddi motility

作　　者：石刚[1] 吴硕东[2] 刘波[1] 孙巍[1] 张小博[2] 孔静[2] 

机构地区：[1]沈阳市第四人民医院肝胆外科沈阳市胆石疾病诊治中心,辽宁省沈阳市110020 [2]中国医科大学盛京医院普外科,辽宁省沈阳市110036

出　　处：《世界华人消化杂志》2010年第20期2150-2154,共5页World Chinese Journal of Digestology

摘　　要：目的:观察在消化间期,常规剂量的多潘利酮、莫沙必利、替加色罗对Oddi括约肌(sphincter of Oddi,SO)运动功能的影响.方法:胆道探查术后留有T型管患者32例,进行前瞻性病例对照研究,采用抽签法随机分为潘利酮组、莫沙必利组、替加色罗组,测量用药前后的十二指肠压(DP)、SO基础压(SOBP)、收缩波幅(SOCA)、收缩频率(SOF)、收缩间期(SOD)及胆总管压(CBDP).结果:舌下含服多潘利酮后SOBP明显降低(10.30±4.99vs6.40±3.66,P<0.05),SOCA明显降低(110.52±37.80vs68.67±41.02,P<0.05);舌下含服莫沙必利后SOBP和SOCA明显降低(12.56±13.02vs6.00±5.74;83.44±46.16vs52.48±44.19,均P<0.05);舌下含服替加色罗后,SOCA、SOBP无明显变化.应用各药物后,SOF、SOD及CBDP均无明显变化.结论:常规剂量的多潘利酮、莫沙必利对SO运动功能具有抑制作用,引起Oddi松弛;常规剂量的替加色罗可能对SO运动功能无明显影响.AIM：To observe the effects of domperidone,mosapride and tegaserod on the motility of human sphincter of Oddi（SO） and to analyze potential mechanisms involved. METHODS：Thirty-two patients with T-tube drainage after choledochotomy were randomly divided into three groups：domperidone group,mosapride group and tegaserod group.The pressure of the SO was measured with a choledochofiberscope via T-tube fistula.Agents were given sublingually.Basic pressure of the SO（SOBP）,amplitude of the SO（SOCA）,duration of phasic contractions（SOD）,duodenal pressure（DP）,and common bile duct pressure（CBDP）were recorded and analyzed. RESULTS：SOBP and SOCA decreased markedly not only in the domperidone group（10.30 ± 4.99 vs 6.40 ± 3.66;110.52 ± 37.80 vs 68.67 ± 41.02;both P〈0.05） but also in the mosapride group（2.56 ± 13.02 vs 6.00 ± 5.74;83.44 ± 46.16 vs 52.48 ± 44.19;both P〈0.05）.SOBP and SOCA did not change after tegaserod intake.No significant changes in SOF,SOD and CBDP were noted in all the groups. CONCLUSION：Both domperidone and mosapride at clinical doses decrease SOBP and SOCA and inhibit SO motility,while tegaserod at clinical dose does not affect SO motility.

关 键 词：ODDI括约肌 多潘利酮 莫沙必利 替加色罗 压力 

分 类 号：R657.4[医药卫生—外科学]