摘要
目的 探讨西沙必利提高胆囊结石患者胆囊收缩功能及其防石和排石作用。方法 应用Ｂ超对比研究口服西沙必利前后健康对照组（９例）及胆囊结石组（２１例）胆囊大小，周长，面积和脂餐后6０～１２０分钟间最大胆囊收缩率（ＰＲＧＣ）的差异。结果 结石组 ＰＲＧＣ（２．６％±１７．３％）明显低于对照组（５４．７％±１１．３％），Ｐ＝０．０００３。结石组空腹胆囊面积（１８．３±１１．８ ｃｍ２）大于对照组（１．１２±２．１４ ｃｍ２），Ｐ＜ ０，０５。口服西沙必利前后两组胆囊周长，面积的变化差异均无显著性。结石组ＰＲＧＣ服药后（４１．１％±１４．７％）较服药前（２７ ５％±１４．７％）有明显提高，Ｐ＝０ ０１３４，ＰＲＧＣ提高者１１／１３（８４．６％）。两组 ＰＲＧＣ的提高幅度与服药前 ＰＲＧＣ呈负相关，ｒ＝－０．５１９２，Ｐ＝０．０２７２。结论 胆囊结石患者的胆囊存在动力障碍，空腹胆囊面积大于正常人而收缩功能明显低于正常。西沙必利对正常人和胆囊结石患者均能明显提高脂餐后胆囊收缩功能，提高幅度与服药前ＰＲＧＣ成负相关。
Aim: It was to be ascertained whether gallbladder contraction function could be improved by taking cisapride orally. Methods The size, circumference, area and the largest con-traction rate of gallbladder(CRG) after fat meal were compared between the control group(9 subjects ) and the stone group(21 cases), and between those before and after taking cisapride orally, by ultrasonography. Results There was a lower CRG in the stone group(28.6 ± 17.3%) as compared with that in the controls(54.7% ± 11.3%, P = 0.0030). The mean area of fasting gallbladder was significantly larger in the stone group(18. 3 ± 11. 8 cm2) than in the controls(12. 1 ± 2. 14cm2, P< 0. 05), but no significant differences in circumfer-ence and area of the gallbladder before and after cisapride administration were found. There was a significant increase of CRG(41. 1% ± 14.7% )in the stone group after taking cisapride in comparison with that before taking cisapride(27. 5% ± 14. 7%, P 0. 0134) . The in-creased CRG was seen in 11 out of 13 patients with gallbladder stone(84.6%). Based on the CRG before taking cisapride, there was a negative correlation between increased degrees of CRG in two groups,(r =-0. 5192) . Conclusions Cisapride has the effect on improving gallbladder contraction function after fat meal in subjects with or without gallbladder stone, with an effect rate of 81. 8%(18/ 22) . There is a negative correlation between increased degrees of CRG in two groups.
