摘要
背景:胃起搏治疗胃动力紊乱性疾病已引起人们的关注,但其作用机制尚不清楚。目的:研究胃起搏对胃动力紊乱犬胃肌电活动和血浆胃动素水平的影响,观察胃起搏治疗前后胃电参数与血浆胃动素含量的相关性,进而探索胃起搏的作用机制。方法:采用双侧迷走神经干切断术联合应用胰高血搪素建立胃动力紊乱或节律紊乱犬模型。采用4导联胃肠电系统微机分析仪记录胃浆膜肌电活动:采用放射免疫法测定血浆胃动素含量。采用适宜的起搏参数从腹部体表驱动胃电慢波,1次d,每次45min,疗程为30天,均在餐后进行。结果:双侧逃走神经干切断术后,模型犬的餐后胃电主频(4.85 cpm±0.40 cpm)、平均幅度(2.32 mV±0.35 mV)和慢波传播速度(4.06 cm/s±0.40cm/s)均较止常对照犬显著降低(5.37 cpm±0.36 cpm,4.25 mV±0.12 mV.6.92 cm/s±0.24 cm/s,P<0.03),其术后血浆胃动素含量(242.09 pg/ml±17.22 pg/m1)显著高于术前(184.29 pg/ml±9.81 pg ml,P<0.01),且胃电主频、平均幅度和慢波传播速度与胃动素含量呈负相关(P<0.04)。经胃起搏治疗后,模型犬的餐后胃电主频(5.49cpm±0.31 cpm)、平均幅度(3.97mV±0.19mV)和慢波传播速度(5.57 cm/s±0.48 cm/s)均显著高于治疗前(P<0.05),血浆胃动素含量(212.55 pg/ml±11.20 pg/ml)
Background: Gastric pacing has been paid close attention as a therapeutic modality for gastric motility disorders; but its mechanism is still not clear. Aims: To investigate the effects of gastric pacing on gastric myoelectrical activity and the plasma level of motilin in the canine model with gastric motor disorders; and to explore the correlation between gastric myoelectrical parameters and the plasma concentration of motilin before and after pacing, in order to investigate the mechanism of gastric pacing. Methods: The canine model with gastric motor disorders or dysrhythmias was established by truncal vagotomy combined with injection of glucagon. Gastric serosal myoelectrical activity was recorded using four-channel computer analysis instruments; the plasma concentration of motilin was estimated by radioimmunoassay. Using the optimal pacing parameters, surface gastric pacing was applied to entrain gastric slow wave, it was performed 45 min per day for 30 days after meal. Results: Basic electrical rhythm (HER) frequency (4.85 cpm+0.40 cpm), amplitude (2.32 mV+0.35 mV) and propagation velocity (4.06 cm/s+0.40 cm/s) of the model dogs underwent truncal vagotomy in the fed state decreased significantly than those of the normal controls (5.37 cpm +0.36 cpm, 4.25 mV+0.12 mV and 6.92 cm/s +0.24 cm/s, P<0.03). Compared with that before surgery, the plasma concentration of motilin in model dogs raised obviously from 184.29 pg/ml +9.81 pg/'ml to 242.09 pg/ml+ 17.22 pg/ml (P<0.01), and there existed an equally negative correlation between BER frequency, amplitude and propagation velocity and the concentration of motilin (P<0.04). After gastric pacing, BER frequency (5.49 cpm+0.31 cpm), amplitude (3.97 mV+0.19 mV) and propagation velocity (5.57 cm/s +0.48 cm/s) of model dogs increased significantly than those before pacing (P<0.05). The plasma concentration of motilin (212.55 pg/ml+11.20 pg/ml) was reduced significantly in comparison with that before treatment (P<0.02), and there showed an equally positive correlation between BER frequency, amplitude and propagation velocity and the concentration of motilin (P<0.02). Conclusions: Using the optimal pacing parameters, surface gastric pacing is able to entrain the gastric slow wave completely, which may improve the parameters of gastric myoelectrical activity and normalize the gastric dysrhythmias induced by pharmacological agent. Gastric myoelectrical parameters are well correlated with the plasma concentration of motilin before and after pacing. Motilin may participate in the mechanism of gastric pacing through altering the gastric myoelectrical activity.
出处
《胃肠病学》
2003年第1期15-19,共5页
Chinese Journal of Gastroenterology
基金
本课题由2001年度第三军医大学西南医院创新基金资助
