红霉素在消化道不同节段的促动力作用研究

Different effects of erythromycin on different levels of digestive tract.

本文报告对8条犬在空腹和饱腹状态下行小肠肌电记录。结果发现在空腹时,红霉素打断了十二指肠和空肠的正常传播性肌电综合波,代之以不规则的高耸肌电波形。其快波数分别为812和336增加至2052(P<0.01)和763(P<0.05),而回肠快波数未见明显增加。饱腹状况同空腹,静注红霉素后十二指肠和空肠饱腹波形为高耸肌电收缩波形取代,快波数分别从565和241增加至2022(P<0.01)和763(P<0.05)。而回肠快波数无明显增加,相反在红霉素注射后有明显减少。引起红霉素作用节段性差别的确切机制目前尚不清楚,可能的解释是近端胃肠道平滑肌内的胆碱能神经分布密度比远端高。因此我们认为它较适合用于治疗胃瘫,而对假性肠梗阻可能疗效不佳。

Myoelectrical activity of small bowel in 8 dogs were recorded. The results showed that migrating myoelectrical complex in the fasted dogs was interrupted by erythromycin (EM) and replaced by irregular electrical activity. Spike numbers of duodenum and jejunum were increased from 812 and 336 in the control period to 2052 (P<0.01) and 763 (P<0.05) in the EM period. However, the spike number of ileum was not significantly different between the control and EM periods. Similar results were found is the fed dogs. After EM the postprandial pattern was interrupted and replaced by high amplitude electrical activity. The spike numbers of duodenum and jejunum were increased from 565 and 241 in the control period to 2022 (P<0.01)and 763 (P<0.05)in the EM period. There was no significant change in the ileum. Although the spike number of ileum after EM was decreased there is no statistical difference. In conclusion EM can be used as a prokinetic agent in treatment of gastroparesis but no pseudoobstrucion of distal intestine.