多潘立酮在增强胃十二指肠协调运动中的作用

Enhancement effect of domperidone on gastroduodenal coordination

目的观察多潘立酮对增强消化间期移行性复合运动(MMC)及促进胃窦十二指肠协调运动的有效性。方法在体实验:将30只Wister大鼠均分为对照(生理盐水)组、多潘立酮组和莫沙必利组。在各组大鼠胃窦、幽门和十二指肠埋植应力传感器,记录MMC及测定胃窦十二指肠协调运动。离体实验:应用血管灌流(Krebs-Ringer液、多潘立酮、阿托品+多潘立酮、河豚毒素+多潘立酮或莫沙必利)大鼠离体胃十二指肠制备。在胃窦和十二指肠缝一应力传感器,记录胃和十二指肠运动及测定胃窦十二指肠协调性。结果在体实验:①清醒大鼠消化间期出现典型MMCⅠ、Ⅱ、Ⅲ、Ⅳ相。②多潘立酮可明显增强MMC的收缩运动,使胃窦和十二指肠平均振幅分别比对照组增加85.1%±11.4%和83.0%±6.3%。③多潘立酮可明显增加MMC胃窦十二指肠协调运动,由胃窦引发的十二指肠收缩波比对照组增加91.2%±9.4%。离体实验:①血管灌流多潘立酮可显著刺激离体胃十二指肠运动和胃窦十二指肠协调运动,分别较Krebs-Ringer液组增加66.2%±12.1%和76.5%±5.8%。②阿托品与河豚毒素可阻断多潘立酮兴奋胃十二指肠运动及胃窦十二指肠协调性的作用。结论多潘立酮可明显增加胃窦十二指肠动力及协调运动。多潘立酮促进胃肠动力和协调运动的作用机制,除已知阻断外周多巴胺受体外,还可能通过肠神经系统内胆碱能神经介导。

Objective To observe the role of domperidone on enhancing the interdigestive migrating motor complex （MMC） and facilitating antroduodenal coordination. Methods ① Experiment in vivo： 30 Wister rats were equally divided into control, domperidone and mosapride groups. Strain gauges were implanted on the serosa of antrum, pylorus and duodenum in conscious rats to record MMC and gastroduodenal coordination. ② Experiment in vitro ： isolated vascularly perfused rat gastroduodenal preparations were used and strain gauges were implanted on the serosa of antrum and duodenum to record motility and gastroduodenal coordination. Results Experiment in vivo ： ① Typical MMC with phase Ⅰ , Ⅱ , Ⅲ and Ⅳ was recorded in fast rats. ② Domperidone markedly increased the contraction activity of MMC, The amplitudes of contractile activity of antrum and duodenum were higher than that of control group （85. 1% ± 11.4% and 83.0% ± 6.3%, respectively）. ③ Domperidone markedly increased the antroduodenal coordination. Compared to the control group, the duodenal contractile waves after treatment increased to 91.2% ± 9.4%. The effects of domperidone mentioned above were greater than that of mosapride. Experiment in vitro： ① Domperidone perfused vascularly could significantly stimulate gastroduodenal contraction and antroduodenal coordination in vitro, which were 66.2% ± 12. 1% and 76.5% ±5.8% higher than that of control group, respectively. The effect of domperidone was greater than that of mosapride. ② Atropine or tetrodotoxin could completely block the enhancement effect of domperidone on gastroduodenal motility and antroduodenal coordination. Conclusions Domperidone could increase the gastroduodenal motility and antroduodenal coordination. The effect of domperidone, which is greater than that of mosapride, is mediated by not only the blockage of dopamine receptor, but also the cholinergic pathway of enteric nerve system.