目的:观察阿司匹林肠溶片及肠溶缓释片在不同pH水平体外溶液及人体消化道内的转运及崩解过程。方法:(1)体外实验:将0.9%生理盐水分别与盐酸及碳酸氢钠混合,模拟空腹胃液、餐后胃液及小肠液pH水平,观察阿司匹林肠溶片及阿司匹林肠溶缓释...目的:观察阿司匹林肠溶片及肠溶缓释片在不同pH水平体外溶液及人体消化道内的转运及崩解过程。方法:(1)体外实验:将0.9%生理盐水分别与盐酸及碳酸氢钠混合,模拟空腹胃液、餐后胃液及小肠液pH水平,观察阿司匹林肠溶片及阿司匹林肠溶缓释片在不同pH溶液中的崩解情况。(2)人体研究:选择2020年10~12月在北京大学第一医院老年内科住院治疗且无消化道症状的冠心病患者6例,健康志愿者6例,进行磁控胶囊内镜检查。根据检查过程中服用阿司匹林剂型分为阿司匹林肠溶缓释片组及阿司匹林肠溶片组,观察阿司匹林在消化道内的转运及崩解情况,对比两组患者的临床资料及内镜下相关时间指标。结果:(1)体外实验:肠溶阿司匹林仅在碱性溶液中崩解,阿司匹林肠溶片开始崩解时间更早(0.5~1.0 h vs.3.0 h),崩解速度更快(2.0~3.0 h vs.6.0 h);(2)人体研究:人群中肠溶阿司匹林的胃通过时间差异较大(6~70 min)且与剂型无关(23.0 min vs.23.5 min,P=0.720),3例患者服药后药片嵌入胃底皱襞,平均22.0 min(19.0~25.0 min)后脱落。阿司匹林肠溶片组更早开始崩解(97.5 min vs.182.5 min,P=0.006),崩解速度更快。结论:阿司匹林肠溶缓释片相对于肠溶片,开始崩解时间更晚、崩解速度更慢;建议空腹服用肠溶剂型阿司匹林。展开更多
Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally adminis...Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally administered metoclopramide. Clinical and procedural parameters were recorded prospectively for 150 patients undergoing capsule endoscopy. Metoclopramide was not administered to the first 83 patients (Group 1) but was given orally (10 mg) to the subsequent 67 (Group 2). Small-bowel transit was complete in 63 patients in Group 1 (76%). Gastric transit time was significantly longer when the capsule did not reach the colon than when it did (114.9 ±32.6 minutes vs. 26.6 ±2.9 minutes; p = 0.007). Small-bowel transit time also was longer. The likelihood of complete small-bowel passage was not predicted by any clinical or procedural factor. In Group 2 (metoclopramide), the capsule reached the colon in 65 (97%) patients (OR 10.3: 95%CI[2.32, 93.55], p < 0.001). This improvement was associated with a significant reduction in gastric transit time (47.9 ±9.0 minutes vs. 30.8 ±7.5 minutes; p = 0.025). Metoclopramide increases the likelihood of a complete small-bowel examination in patients undergoing capsule endoscopy.展开更多
文摘目的:观察阿司匹林肠溶片及肠溶缓释片在不同pH水平体外溶液及人体消化道内的转运及崩解过程。方法:(1)体外实验:将0.9%生理盐水分别与盐酸及碳酸氢钠混合,模拟空腹胃液、餐后胃液及小肠液pH水平,观察阿司匹林肠溶片及阿司匹林肠溶缓释片在不同pH溶液中的崩解情况。(2)人体研究:选择2020年10~12月在北京大学第一医院老年内科住院治疗且无消化道症状的冠心病患者6例,健康志愿者6例,进行磁控胶囊内镜检查。根据检查过程中服用阿司匹林剂型分为阿司匹林肠溶缓释片组及阿司匹林肠溶片组,观察阿司匹林在消化道内的转运及崩解情况,对比两组患者的临床资料及内镜下相关时间指标。结果:(1)体外实验:肠溶阿司匹林仅在碱性溶液中崩解,阿司匹林肠溶片开始崩解时间更早(0.5~1.0 h vs.3.0 h),崩解速度更快(2.0~3.0 h vs.6.0 h);(2)人体研究:人群中肠溶阿司匹林的胃通过时间差异较大(6~70 min)且与剂型无关(23.0 min vs.23.5 min,P=0.720),3例患者服药后药片嵌入胃底皱襞,平均22.0 min(19.0~25.0 min)后脱落。阿司匹林肠溶片组更早开始崩解(97.5 min vs.182.5 min,P=0.006),崩解速度更快。结论:阿司匹林肠溶缓释片相对于肠溶片,开始崩解时间更晚、崩解速度更慢;建议空腹服用肠溶剂型阿司匹林。
文摘Passage of the capsule endoscope to the colon occurs in only approximately three quarters of patients. This study assessed factors that might influence the completeness of small-bowel transit, including orally administered metoclopramide. Clinical and procedural parameters were recorded prospectively for 150 patients undergoing capsule endoscopy. Metoclopramide was not administered to the first 83 patients (Group 1) but was given orally (10 mg) to the subsequent 67 (Group 2). Small-bowel transit was complete in 63 patients in Group 1 (76%). Gastric transit time was significantly longer when the capsule did not reach the colon than when it did (114.9 ±32.6 minutes vs. 26.6 ±2.9 minutes; p = 0.007). Small-bowel transit time also was longer. The likelihood of complete small-bowel passage was not predicted by any clinical or procedural factor. In Group 2 (metoclopramide), the capsule reached the colon in 65 (97%) patients (OR 10.3: 95%CI[2.32, 93.55], p < 0.001). This improvement was associated with a significant reduction in gastric transit time (47.9 ±9.0 minutes vs. 30.8 ±7.5 minutes; p = 0.025). Metoclopramide increases the likelihood of a complete small-bowel examination in patients undergoing capsule endoscopy.
