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目的 观察加贝酯对Oddi括约肌运动功能的影响。方法 对我院 12例行内镜下逆行胰胆管造影 (ERCP)患者于内镜下作Oddi括约肌测压术 ,记录Oddi括约肌的基础压、基础收缩幅度、收缩频率和运动指数 (基础收缩幅度×收缩频率 ) ,并在静脉滴注加贝酯 1、3mg·kg-1·h-1前后 ,分别重复以上测压过程。以用药前后记录数据作自身对照配对t检验进行统计学处理。结果 ①静脉滴注加贝酯1、3mg·kg-1·h-1不影响Oddi括约肌的基础压 (P >0 .0 5 )和基础收缩幅度 (P >0 .0 5 )。②加贝酯能明显减少Oddi括约肌的收缩频率 (P <0 .0 5 ) ,但用药剂量 1、3mg·kg-1·h-1之间差异无显著性 (P >0 .0 5 )。③大剂量加贝酯可明显降低Oddi括约肌运动指数 (P <0 .0 1) ,且 3mg·kg-1·h-1与 1mg·kg-1·h-1剂量间差异也有显著性 (P <0 .0 5 )。结论 加贝酯能减少人Oddi括约肌的收缩频率 ,3mg·kg-1·h-1时还能降低运动指数。加贝酯对Oddi括约肌运动的影响可解释加贝酯减少ERCP后胰腺炎的发生。
Objective To observe the effects of Gabapeptide on the motor function of Oddi sphincter. Methods In our hospital, 12 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) underwent endoscopic sphincterotomy with Oddi sphincter. The basal pressure, basal systolic pressure, systolic frequency, and motor index (basal contraction amplitude × Systolic frequency), and before and after intravenous drip gabapentin 1,3 mg · kg-1 · h-1, respectively, to repeat the above pressure measurement process. Data were recorded before and after treatment for self-control paired t-test for statistical analysis. Results ① Intravenous infusion of gabexate 1,3 mg · kg-1 · h-1 did not affect the baseline pressure (P> 0.05) and basal contraction amplitude of Oddi sphincter (P> 0.05). ② Gabapeptide significantly reduced the contraction frequency of Oddi sphincter (P <0.05), but no significant difference was found between the dose of 1,3 mg · kg-1 · h-1 (P> 0.05). (3) Large dose of gabexate can significantly reduce the Oddi sphincter index (P <0.01), and the difference between 3 mg · kg-1 · h-1 and 1 mg · kg-1 · h-1 dose was also significant <0 .0 5). Conclusion Gabapeptide can reduce the contractile frequency of human Oddi sphincter and decrease the motor index at 3 mg · kg-1 · h-1. The effect of Gabapeptide on Oddi’s sphincter movement may explain the effect of Gabapenem on the reduction of post-ERCP pancreatitis.