替尔泊肽是否会减慢胃排空？

替尔泊肽可延迟胃排空，且该作用随时间推移而减弱。

对胃排空的影响

替尔泊肽可延迟胃排空。首次给药后延迟程度最大，且该作用随时间推移而减弱。¹

替尔泊肽与胃肠道不良反应相关，包括恶心、呕吐和腹泻。这些事件可能导致脱水，进而可能引起肾功能恶化，包括急性肾衰竭。胃肠道事件的严重程度大多为轻度或中度。恶心、呕吐和腹泻的发生率在剂量递增期较高，并随时间推移而降低。¹

尚未在重度胃肠道疾病（包括重度胃轻瘫）患者中开展替尔泊肽研究，此类患者应慎用。¹

已有与胃排空受损相关事件（包括重度胃轻瘫）的报告。¹

对于治疗期间出现重度胃肠道症状的患者，应进行监测并考虑调整剂量或停药。¹

天然葡萄糖依赖性促胰岛素多肽（GIP）及GIP类似物均未显示出对胃排空的影响。^2-5

胰高糖素样肽-1（GLP-1）受体激动剂给药后胃排空延迟已得到公认，并被假设为导致血糖、食欲和食物摄入减少的因素之一。^6-8

与选择性 GLP-1 RA 受体激动剂相比，替尔泊肽对胃排空延迟有相似影响。²

上次审阅日期：2025年12月9日

参考文献

1. Data on file, Eli Lilly and Company and/or one of its subsidiaries.

2. Urva S, Coskun T, Loghin C, et al. The novel dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist tirzepatide transiently delays gastric emptying similarly to selective long-acting GLP-1 receptor agonists. Diabetes Obes Metab. 2020;22(10):1886-1891. https://doi.org/10.1111/dom.14110

3. Edholm T, Degerblad M, Grybäck P, et al. Differential incretin effects of GIP and GLP-1 on gastric emptying, appetite, and insulin-glucose homeostasis. Neurogastroenterol Motil. 2010;22(11):1191-1200. https://doi.org/10.1111/j.1365-2982.2010.01554.x

4. Meier JJ, Goetze O, Anstipp J, et al. Gastric inhibitory polypeptide does not inhibit gastric emptying in humans. Am J Physiol Endcrinol Metab. 2004;286(4):E621-E625. https://doi.org/10.1152/ajpendo.00499.2003

5. Nauck MA, Baller B, Meier JJ. Gastric inhibitory polypeptide and glucagon-like peptide-1 in the pathogenesis of type 2 diabetes. Diabetes. 2004;53(suppl 3):S190-S196. https://doi.org/10.2337/diabetes.53.suppl_3.S190

6. Flint A, Raben A, Ersbøll AK, et al. The effect of physiological levels of glucagon-like peptide-1 on appetite, gastric emptying, energy and substrate metabolism in obesity. Int J Obes. 2001;25(6):781-792. https://doi.org/10.1038/sj.ijo.0801627

7. Marathe CS, Rayner CK, Jones KL, Horowitz M. Effects of GLP-1 and incretin-based therapies on gastrointestinal motor function. Exp Diabetes Res. 2011;2011:279530. https://doi.org/10.1155/2011/279530

8. Smits MM, Tonneijck L, Muskiet MH, et al. Gastrointestinal actions of glucagon-like peptide-1-based therapies: glycaemic control beyond the pancreas. Diabetes Obes Metab. 2016;18(3):224-235. https://doi.org/10.1111/dom.12593