西沙比利对糖尿病胃轻瘫患者胃运动功能及血浆胃动素的影响

Study of Interdigestive Migrating Motor Complex and Plasma Motilin Concentration in Diabetic Gastroparesis

为探讨糖尿病胃轻瘫 (DGP)时空腹胃运动功能及胃动素的改变 ,观察西沙比利对DGP的治疗作用 ,对 1 2例健康志愿者和 3 2例糖尿病患者进行胃十二指肠压力测定 ,于消化间期移行性复合运动 (MMC)各期取血测血浆胃动素 (MTL) ;并将 3 2例糖尿病患者均分为 2组 ,一组口服西沙比利 ,另一组选择不影响胃动力的药物进行治疗 ,2周后复查。结果 :①糖尿病患者MMC异常 ,表现为 3期缺乏 ,2期持续时间延长 ,2期动力指数 (MI)及 3期波幅降低。②正常人MTL随MMC运动呈规律性变化 ,2期末达到高峰 ,糖尿病患者MMC各期MTL均明显高于对照组。③应用西沙比利治疗后 ,MMC 3期出现率升高 ,2期持续时间缩短 ,MI及 3期波幅升高 ,MTL下降。提示糖尿病患者MMC明显异常 ,胃窦运动减弱可能不是缘于胃动素缺乏 ;西沙比利在改善糖尿病患者MMC的同时 ,使MTL降低。

The study is to observe the changes of gastric motility and motilin in diabetic gastroparesis(DGP) and to determine the effects of cisapride therapy in DGP. Twelve normals and 32 diabetic patients participated. Basal gastric motility was studied in both groups and plasma motilin(MTL) concentration was studied in each phases of MMC. Thirty two diabetic patients were equally divided into 2 groups. Cisapride was orally administered in group one while non prokinetic drug was administered in group two as the control. The same examination was carried out in both groups. Results: ① In diabetic patients, abnormal MMC was characterized by absence of phase 3, prolongation of phase 2, decrease of motor index of phase 2 and amplitude of phase 3. ② In the control group, MTL concentration fluctuated in phases of MMC and reached a peak level in late phase 2. The MTL concentrations of patients were significantly higher than that of the control group and had normal cyclic fluctuations of MTL. ③ After cisapride treatment, MTL concentration were reduced significantly, and the contractile activity, amplitudes in phase 3 and motor index of phase 2 were increased significantly. It showed that gastric motility was depressed in diabetes. Abnormal motility in DGP might not be related to MTL deficiency. Cisapride administration in DGP can improve gastric motility and decrease MTL concentration.