加贝脂对胆总管结石患者Oddi括约肌运动的影响  

Effects of gabexate mesilate on the sphincter of Oddi motility in patients with common bile duct

作　　者：郭志国[1] 辛毅[1] 韩真[2] 

机构地区：[1]安徽省宿州市立医院消化内科,安徽宿州230061 [2]皖南医学院弋矶山医院消化内科,安徽芜湖241002

出　　处：《吉林医学》2012年第22期4753-4756,共4页Jilin Medical Journal

摘　　要：目的:探讨加贝脂对胆总管结石患者Oddi括约肌运动的影响。方法:选择因不明原因的上腹痛、黄疸就诊而行逆行胰胆造影的患者20例,按随机双盲法分成加贝脂(GM组)与对照组,其中行内镜下胆道测压术20例,加贝酯组静脉滴注加贝酯100 mg加0.9%NaCl溶液100 ml以2.5 mg/(kg.h)速度静脉滴入,3 min后重复测压;对照组给予0.9%NaCl溶液100 ml静脉滴注,3 min后重复测压;分别记录Oddi括约肌基础压力(SOBP)、基础收缩幅度(SOCA)、收缩频率(SOF)和运动指数(基础收缩幅度×收缩频率)。结果:加贝酯组与对照组Oddi括约肌测压结果比较,加贝酯组Oddi括约肌的收缩频率较用药前下降,为(P<0.05);Oddi括约肌的基础收缩幅度下降(P<0.05);Oddi括约肌运动指数明显降低(P<0.05),Oddi括约肌基础压无明显影响(P>0.05)。结论:使用常规剂量的加贝酯可以降低胆总管结石患者Oddi括约肌收缩幅度、收缩频率及运动指数,对Oddi括约肌基础压无明显影响。Objective To explore the effects of gabexate mesilate on patients with common bile duct stones sphincter of Oddi （SO） mo- tility. Method Twenty patients were selected randomized divided to two groups suffering from unexplained abdominal pain and jaundice from September 2009 to July 2011 scheduled for ERCP and those who underwent endoscopic sphincter of Oddi manometry （SOM）. Patients in gabexate mesilate group were treated with continuous intravenous infusion of 100 mg gabexate dissolved in 100 ml physiological saline solution by the 2.5 mg/（ kg ~ h） speed vein before SOM;patients in control group were treated only with physiological saline solution during SOM. Three minutes later all of them received repeated pressure measurements. Parameters of SO basal pressure （SOBP） ,the SO contrac- tive amplitude （SOCA） ,the SO contractive frequency （SOF） and motility index （contraction amplitude x contraction frequency） were measured before drugs administration. Results Standard preendoscopic sphincter of Oddi manometry was done during infusion of GM 20 mg/min：basal pressure was unaffected by drug infusion,the average was 42.3 ~9. 5 mmHg （P 〉0. 05） ,while gabexate caused a signifi- cant reduction of phasic activity： both in terms of amplitude and frequency of contractions after intravenous administration of Gabexate com- pared with the data before drugs administration, their averages were 74. 2 ± 12. 3 mmHg（ P 〈 0. 05 ） and 3.5± 1.1 to the minute （ P 〈 0. 05）, respectively,in particular the motility index decreased clearly which average was 226 ± 101 （P 〈 0. 05 ）. Conclusion GM adminis- tration caused a statistically significant reduction of phasi activity,both in terms of amplitude and frequency of contractions and motility in- dex without effects on sphincter of Oddi basal pressure.

关 键 词：加贝脂 ODDI括约肌 测压 

分 类 号：R575.6[医药卫生—消化系统]